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THE 

DOCTRINE OF PURGATION. 



€mmxtm fxam %mmt untt Pob^m "^xitxntxxxt 



A COLLECTION OF QUOTATIONS ON THE USE OF PURGATIVES, 



FBOM 



HIPPOCRATES, 

AND OTHER MEDICAL WRITERS, 

COYERING A PERIOD OF OYER TWQ THOUSAND YEARS, 

PROVING 

JJttrgation 10 tl)e Corner-stone of all (Inratbes, 



COMPILED BY B. BEANDRETH, M. Z>., SING SING, N. T. 
THIRD EDITION. 



■ \ 



NEW TOEK:^ 
BAKER & GODWIN, PRINTERS, 

PRINTINO-HOUSE SQUARE. 
1873. 



/^ 







Entered, according to Act of Congress, in the year 1873, by 

BENJAMIN BRANDRETH, M. D„ 

In the Office of the Librarian of Congress, at "Washington. 



INTRODUCTION TO AUTHORITIES 

FOR 

DOCTRINE OF PURGATION, 

AND 

OPINION AS TO CAUSE OF DISEASE AND PREMATURE DEATH. 



Life maybe considered the union of soul and body. It is one of the most impene- 
trable secrets of Him who lives in all things, and in whom all live, and move, and 
have their being ; who, in His goodness, has led man, as by the hand, to the path 
whereby he may arrive at a knowledge of his bodily infirmities and death ; and how he 
may reduce the one, and thereby keep the other at bay. All nature is God's work, but 
man is the only living creature that appears to be endowed with cumulative reason. 
The Bible tells us he is fallen from his primitive condition of happiness, and in con- 
sequence of this fall, he receives at his birth a germ or principle of corruptibility, 
which continues to be propagated throughout all time. For the child receives from 
his parents the principle of his life, and also that of his death — corruption. From 
long study and experience, we are convinced that the death principle is corruption, 
or therein contained. The examination of the dead proves this ; the putrefaction 
we observe tells us plainly that if that had been removed in time, life would not 
have been extinguished. The principles of life and death occupy the same body, 
and one or the other must rule. In order, therefore, that we continue in health, the 
principle of life must have the balance in its favor. Our method teaches this impor- 
tant knowledge. Some writers fix old age at between fifty and sixty years. Every 
five years that a man lives after this period may be set down as a degree added to 
old age. If there are so few who reach an advanced period of life, it is because the 
innate principle of corruption becomes active, and disease breaks out with more or 
less malignity, and the proper means not being employed, death may follow, f- e 
individual not having reached- that age he should and ought to have attained from 
the principle of life which he possessed. We look upon this as premature, not nat- 
ural death. Natural death is a cessation of all the faculties ; the man or woman 
falls asleep, ceasing to exist without effort or struggle. 

It is true that all men must die, but no one need die of disease. Even now, hu- 
man beings have a longer average of life than was their lot in the last century. This 
may be the consequence of a better knowledge of the laws of life. Let it be com- 
prehended that we carry within ourselves the cause of disease and death ; let us 
admit this fact, and not wait until convinced by the terrible manifestations of pain 
and inflammation. 

To apply the remedy in time is the knowledge needed. It is worthy of remark, 
and we see with surprise, that young persons, apparently in the full vigor of health, 
whose complexions seem to indicate the most robust constitution, are oftener attacked 
by severe disease than persons always pale and feeble. These persons have more 
vitality, which occasions a quicker waste or change in the material of their bodies, 
so that when they are sick, unless the secretions are restored immediately, the death 
principle gaias the ascendency. Prompt measures in the right direction are all that 
is needed, and in such cases purgation means life, and the want of it means death. 



4 THE DOCTRINE OF PURGATION. 

Some persons are peculiarly blessed with liealth. In their constitutions no im- 
purity shows itself, often taking one hundred years or more to wear out the " spark 
of life." In others, life has ceased before birth, and the child is still-born. 

All the solid parts of our bodies are made from fluid ; first derived from the 
blood of the mother, then from the mother's milk. Thus solids and fluids constitute 
our material being. 

WASTE AND REPAIR. 

The body wears. Movement causes waste. The hardest steel wears away when 
Used. So also the body wears away, but, unlike the steel, it is renewed faster than it 
wears away in a child, which is the occasion of its growth. It is a great truth, we 
die daily ; but the food consumed also supplies us with new life daily. These are 
marvelous facts ; this decay and renewal are among the wonderful mysteries of the 
Almighty. 

We know the hair and nails grow. Mark your finger nail near the root. 
Day by day it advances toward the end ; at length we pare the mark away. The 
whole nail has been renewed, the growth was supplied, the waste was repaired. 
The same waste, the same renewal occurs in the nose, and all other parts, though we 
cannot mark the change as in the finger nail. 

WHERE THE REPARATIVES ARE. 

The substance which is to form the nail is in the bl od ; as perfectly mixed as a 
grain of salt is dissolved in a glass of water. As the blood circulates in the small 
vessels at the root of the nail, this nail substance deposits and organizes itself, and 
replaces what is worn away. The hair is also renewed by materials from the blood 
deposited in the roots of the hair ; so the bones ; and so the flesh ; and so with all 
other tissues and parts of man's body. Each part receives its needed supply of new 
material. Thus the eye retains its fire, the tongue its power of utterance, the 
brain the power of thought. 

Analogy tells us even the brain, the organ of thought, wears, and is renewed by 
the blood, which circulates and renews all the parts of the body alike, whether it be 
brain, spinal cord, the eye, the bones, the flesh, the .^a^r, or the nail. 

The blood carries new material to repair the waste, and it reloads itself with 
worn-out parts which it discharges through the appropriate vents. When the new 
materials are greater than the waste, the child grows ; or the man spreads. When 
the waste is exactly equal to the new material, the body remains of the same size 
and weight. These facts indicate that all substance of all the organs and parts of a 
living body are present in the blood. It is therefore important to our well-being 
that this life fluid should be free from imperfections. 

For if the blood does not contain all the needed ingredients, or if it should 
contain more, it cannot fenew the different parts according to their requirements. 
Deformed and ill-made people owe their infirmities to the blood of their parents ; 
pure blood cannot do otherwise than make perfectly organized beings, thus we may 
estimate the value of certain means to make the blood perfect. 

Food, by its organ the stomach, supplies all the p rts of which blood is made. 
We now speak of this conversion. 

DEFIJSriTION. 

eUBSTAKCES WHICH CONTAIN AND SUPPLY ^JTRITION AKE FOOD. 

Healthy food possesses substance, because the stomt) > cannot grind it well with- 
out it possesses this quality. Too fine food makes tL stomach weak ; it cannot 



INTRODUCTION. 5 

use its muscular power, and debility of the stomach follows. If we do not walk, our 
legs soon become weak. To be strong, organs need exercise. When food is digested, 
part makes blood ; the refuse passes off by the bowels, the kidneys, and the skin. 
Our stomach, if properly supplied, continually prepares new blood, which renews all 
the organs, carrying vitality to the hair and nail as well as to the head, with its 
master-organ the brain. Every part is each moment of our lives changing, the worn- 
out parts carried away, and new parts supplied, whether good or bad. Here we see 
the necessity of eating and drinking several times a day. We constantly wear and 
constantly repair. Such is the law of our being. 

WOBN-OUT PARTS MUST BE EXPELLED. 

The worn-out parts must be expelled from the body daily, or the blood will be- 
come impure. We may comprehend this by an inquiry respecting new-born chil- 
dren^ They have taken no food by the mouth, and yet when born their bowels and 
bladders are full. Whence did these secretions come ? They came evidently from 
the blood of the mother, which made their bodies. We also know that sick persons, 
who eat no food for days, have evacuations by the kidneys and bowels. These parts 
are also the worn-out parts of the blood. 

The blood is, in fact, a messenger which takes to every part of the body what it 
needs for renewal, and also carries back to the bowels, kidneys, and skin, worn-out 
substance to be expelled from the body. 

We therefore must admit that every part of a human body is made from blood; 
and that it wastes and is repaired; that food makes blood, which is distributed with 
singular intelligence to all the various organs. 

HOW IMPURE BLOOD IS DEVELOPED. 

The bowels may be costive ; in this case there is an absorption into the circulation, 
of gases and gummy substances, which are a great cause of poison to the blood. 
Should the kidneys fail to do their work, another source of poison to the blood is 
developed. Again, should the perspiration be checked, matters flow back upon the 
blood which soon load it with impurities. Suppose only the feet, by cold, cannot 
perspire, and their fetid exhalations flow back upon the blood. If all these outlets 
— the skin, the kidneys, and the bowels — do their work even imperfectly only, for a 
short time, it is evident that the blood will be burdened with noxious matters, which 
must interfere seriously with the circulation, and soon clog up the smaller vessels, so 
that only a small amount of blood can pass. Soon the lungs, the intestines, the 
stomach, and the brain will sound an alarm. You will have pleurisy^ inflammation 
of the bowels or severe cholic, violent headache, or sick stomach. Because the 
worn-out parts of the body, instead of being carried out by those avenues nature 
designed, are shut up, poisoning the blood, thus causing it to become impure. 

Other causes besides these produce impurity of blood. The food may not be 
healthy ; digestion may be imperfect ; troubles, grief, anxiety, miasmas from swamps 
or other exhalations; breathing close air in crowded rooms; staying in too hot 
rooms ; all these causes tend more or less to vitiate the blood. Grief, fear, and 
anxiety, Tiurt^ ty making the Mood to circulate slower^ and soon produce a very serious 
injury to the composition of the blood, occasioning stubborn fevers, and various 
derangements of the body and mind. 

The best part of food makes chyle, which is absorbed into the circulation, to 
repair the waste the blood sustains in rebuilding the body, and in forming bile and 



6 THE DOCTRINE OF PURGATION. 

all the otlier fluids of the body — for all the fluids are made from the blood. The 
coai-sc portions, and those not needed, are expelled daily by the bowels, the kidneys, 
and the skin. 

The fluids, or as some writers call them, the humors, are as natural and necessary 
as the blood. It is not from humors we are sick, but from the humors becoming 
unsound ; from infection, or absorption of fungi, or other poisonous vapors or matters. 
These produce a putrid fermentation, or chills and fever, or fevers continued or in- 
termittent. 

It is supposed that in the humors resides the germ of corruptibility, which is 
aroused into activity by the above causes. 

To have humors is as natural as to have blood. It is not having humors that causes 
us to be sick, but because they become corrupted. The humors absorb infection, in 
consequence of their being the seat of the innate germ of corruption. When this 
germ or root, from any cause, receives an increase, it may show itself by colds, ca- 
tarrhs, tumors, or other effects, by which life may be shortened, or a serious attack 
of some specific disease produced. 

Corrupted humors always cause sickness ; they cause death. If they are removed 
in time, the sickness is cured, and death prevented. "We know they can be removed, 
and should not corruption be quickly removed from a living body ? Their infec- 
tious smell tells of their hurtful nature to a living body ; cleanse, sweep out from the 
bowels and blood the unhealthy parts, and your disease will soon be cured. 

While in health, the humors and the blood are sound ; but so soon as you do not 
feel well, be sure the humors and blood are getting deranged in their sound quali- 
ties ; and when painful sensations are felt, we should at once take steps to prevent 
serious trouble. These steps usually are evacuation, for we cannot recover health 
until the blood and the humors are freed from all acrid and unhealthy qualities, 
however acquired. 

The humors, after becoming corrupted, soon accumulate a degree of acrimony or 
burning heat, that the burning sensation is often almost insupportable. They often 
resist great quantities of purgatives, but outward applications are really useless 
without evacuation of the bowels. 

Two hundred medical writers, running through a period of over two thousand 
years, agree as to the means of reducing this death principle — agree as to a general 
indication — agree as to the perfect innocence of purgation. We hold that this 
evidence is important in our intelligent age, and hope it may lead to a more uniform 
and a more humane method of treating patients. Perhaps a wise regard for the im- 
provement of the human race will make purgation the principal curative reliance ; 
other means should be only secondary. Physicians may soon be governed by this 
rule, because purgation may be set down as the magnet, the guide, the star of safety. 

Purgation corrects errors in the digestive organs ; and Dr. Abemethy observes 
(in Surgical Observations^ p. 33): "By correcting the obvious errors in the state of 
the digestive organs, local diseases which had baffled all attempts at cure by local 
means, have speedily been removed." When local applications are applied, they 
should be in harmony with purgation, and incapable of doing injury. 

We can remove disease in two ways : by the upper and by the lower passages — 
by vomiting and by purging — purging when the patient is weak, vomiting only 
when he is strong. We will define purgation as " cleansing," and apply to both the 
upper or lower ways. 



INTRODUCTION. 7 

For forty years I have directed my attention to the cure of disease on this plan, 
and facts derived from experience have long since confirmed me in the belief that 
this is calm Nature's own method of cure, because it assists her in removing impuri- 
ties by the means and outlets she has so wisely provided for herself. 

Believing that all mineral and chemical agents which can act on foreign or im- 
pure matters in the blood, invariably injure the organization of the blood itself — 
destroying its corpuscles, besides injuring the coats of the stomach, and producing 
serious effects upon the bones — I have therefore discarded minerals and chemicals 
entirely, and trust to vegetable remedies alone. 

That which I have principally employed to enforce this theory has been Brand- 
reth's Pills, whose permanent and wide-spread success is the strongest evidence of 
their distinguished merit. 

The question has been asked. If the value of this medicine is so great, is it not a 
duty to make known its true components, so that physicians and others could pre- 
pare it ? To this it may be answered, that if Brandreth's Pills certainly would be 
made the same as they are now, and all their healing, cleansing and innocent quali- 
ties retained, one of the reasons for their remaining a secret medicine would be 
removed. 

But every man knows, who knows anything of the drug and medicine business, 
that not one box in a hundred would be prepared of such medicines as are incorpo- 
rated in the Brandreth Pills prepared by me. It is true the pills might be composed 
of ingredients called ly the same name\ but the name would be all the resemblance 
they would ]30ssess to the pure extracts and medicinaL preparations which comprise 
the composition of Brandreth's Pills. • 

Therefore, for the sake of the lives and health of men — for the sake of the 



GREAT SANATORY THEORY OF PUR«3A110N— 

the manner of preparing Brandreth's Pills will never be divulged, until the time 
arrives when all the drugs of the stores shall be true and uniform preparations. 

I am not without examples for this decision : 

Dr. James, the celebrated author of James' Powder, left his prescription to Messrs. 
Newbery & Sons, of London, more than a hundred years ago, by whom they are yet 
made. The great Stahl and Hoffman, of Germany, Professors of Physic at Halle, 
without scruple confined many medicines to their own private practice. And even 
in our own time, there are few medical men of extensive practice who ha-^ie not rem- 
edies which they carefully retain in their own families, who are more likely to prepare 
them with reference to securing their curative effects, without regard to profit, than 
they would be in the hands of strangers. 

The quotations from the writings of medical men, embodied in this pamphlet, 
prove the talent that has been at work upon this Theory of Purgation for over a 
period of two thousand years —and in vain. Then what has prevented its complete 
success ? Simply this, in my opinion : Not a single writer has given a medicine 
which, out of their own hands, would successfully and safely enforce the purgative 
theory. 

The public, in Brandreth's Pills, have a medicine which it is intended shall ever 
be within its reach, always certain to purge only impurities from the blood, and 
when the upper ways require cleansing, occasion vomiting ; and that is safe for both 



8 THE DOCTRINE OF PURGATION. 

sexes and all ages. Composed of vegetable preparations entirely — indeed, the Pills 
are guaranteed to contain no mineral in any form — tliey may, if the req^uirement of 
the constitution need them, be taken daily for any length of time, without a possi- 
bility of producing any bad effects on the body, and must reduce the sum of disease. 



WAEEANTEE. 1 

, t 

That Brandreth's Pills, in all future time, are warranted to 
possess and contain those purgative, those cleansing and innocent 
qualities, which they have always heretofore possessed in so 
eminent a degree. 

The principle of curing disease by the use of purgatives is beginning to be exten- 
sively recognized as indispensably necessary for the recovery of health by many 
intelligent families and individual. To prove to them and to the world at large, as 
well as to physicians of all schools, the broad and deep foundations and authority 
this principle of cure possesses, I have printed the following extracts which, as in a 
mirror, is exhibited the views, and experience, and sentiments of medical men, dur- 
ing a period of over two thousand teabs. 

They possess a peculiar significance for those who desire to investigate this sub- 
ject, so important to the lives and health of men, because they throw a flood of light 
on the application of purgatives as a means of removing disease from the system. 

The great aim byraany of these writers is, that in the administration of medicine, 
we should do good possibly, but never lia/rm. 

Bleeding, Mercury, Tartar Emetic, Antimony, Veratria, Strychnine, Morphine, 
and a host of similar remedial agents may, nay generally do, a great deal of harm, 
and often are the occasion of fatal mistakes ; while the great advantage of using 
Brandreth's Pills in sickness is, that they never male any mistakes^ often prolonging, 
never shortening life. 

In pleurisy, in inflammation, in fevers, and where pain is present, their prompt 
and energetic administration is often life-saving, and it is in evidence they have 
often effected cures when physicians and friends had given up all hope. Then what 
risk does any man or woman incur in using a medicine like Brandreth's Pills, which 
are the adopted remedy of millions of families living in every part of the civilized 
world ? 

The facts given in the following pages prove that fevers, inflammations, and 
severe pain are only, in reality, so many evidences of healthful constitutional power, 
and that if purgation is enforced according to the necessities of the case, the fever, 
severe pain, or inflammation will be removed, provided no sedatives or narcotics 
are employed. 

B. BRANDRETH. 
Sma Sing, June 1, 1871. 



Hippocrates. 



Purgation the Corner-stone of Curatives. 



Hippocrates. — Aphorisms, written about 400 b. c. 
Marhs, M. D., New Yarh, 1818. 



Edited hy Elias 



1. Life is short, art long, Occasion brief, experience fallacious, Thegoiden 



judgment difficult. It is requisite that the physician exhibit what is 
essential, and that the patient, attendants, and all which surrounds him, 
concur therein (1, sect. I). 



rule. 



2. In diarrhea and spontaneous vomiting, if the matter voided be of Diarrhea. 



a nature that ought to be expelled, let the patient be purged, for in this dSed 
case the evacuations are benehcial and are easily supported (2. sect. I). 



Purgation in- 



nature. 



3. The greater the evil the more vigorr as the remedy (6, sect. I). 



The power 
of the reme- 
dy. 



On Diet. 



4. In acute diseases the most violent symptoms supervene; the 
severest regimen is, therefore, to be observed. But if these symptoms 
be wanting, a more generous diet is to be permitted, only we are to 
have recourse to it in proportion to the subsidence of the malady (7, 
sect. I). In the choice of regimen, more evil results from abstraction 
than from a small excess. A thin, frugal, and over-exact regimen curl^^^'^ '^^ 
accords not even with the man in health, who grievously supports the 
privation. Hence, in general, the superiority of a due refection over 
that which is deficient (5, sect. I). 



The nutri- 



5. In those diseases which quickly arrive at their climax, a thin 
regimen should immediately be adopted. In those which attain it at a 
somewhat later period, we should at or before that period, subtract from 
their diet ; but, until then, sufficient nourishment should be allowed, 
that the strength of the patient may be supported (10, sect. I). 



Diet to be 
regulated ac- 
cording to 
the charac- 
ter of the 
disease. 



6. That which is excrementitious should be drawn off at the point 
to which it most tends, by the most convenient outlets (21, sect. I). 



Purgatives, 
Diuretics, 
Sudorifics. 



10 THE DOCTRINE OF PURGATION. 

When to 7. Purgatives should be administered after the food on the stomach 
tives. ^''^^' i^ concocted, not while it is yet crude (22, sect. I). 

XoTE BT THE Editor. — Tlicrc IS HO danger in administering a purgative before or after a 
meal, provided there be pain or dizziness, which symptoms are relieved by purgation . 

8. Depletion is not to be estimated by its copiousness but by its 
How to di- ^^eing judiciously used and easily supported. When it is necessary to 

recMhe pur- extcud it " ad deliquium animi," let it be done, but previously consult 
the resom'ces of the patient (23, sect. I). 

Note by Editor. — Where there is danger of congestion, purgation may be enforced to 
fainting with Brandreth's Pills (see paragraph 55). 

9. If the convalescent acquire not strength from the food he takes, 
it shows that the body needs a more plentiful supply. But if the same 
effect arise from an inability to partake of food, it sufficiently evinces 
the necessity of purgatives (8, sect. II). 

10. When it becomes necessary to purge, the evacuations ought to 
evSatSn°^ bc loosc and free (9, sect. II). 



How to di- 
rect the nou- 
rishment. 



11. Impure constitutions, when most nourished, are most injured 
(10, sect. II). 



Relapses 12. The (morbid) matter remaining in the body after the crisis is 

dent ^^^' P^^^ often produces a relapse (12, sect. II). 

tion. 

Chan e of ^^- ^^ alviuc fluxcs, a chaugc in the dejections, unless they assume 
dejections, a vicious appearance, is beneficial (14, sect. II). 

Tubercles. 14. Whcu the fauccs are affected, and tubercles arise therem, we 

o?S^o?s^^^°^ ought to examine the excretions ; when they are of a bilious nature, the 
entire body is affected ; but if they be as in health, we may safely 
impart nourishment (15, sect. II). 

Disease 15. Exccss of food produccs discasc, and at the same time points out 

from intern- ' - . - . — . - . . . . _ _ . 

perance in 
food or 

gation" the tiou. Thus, oppositcs are counteractives of each other (22, sect. II). 

16. Evacuation, repletion, frigeration, and calefaction — these, or 
_ Sudden ac- any Other correspondent modifications of body, when excessive, or too 
nafurJ^^So- Suddenly accommplished, are dangerous — nature being ever opposed to 
must '^'"^^e ^^^^^'^'^- That which is gradually done is safely done, whether we 
gradual pass from ouc extreme to another, or otherwise (51, sect. II). Every- 
2^. ^^^' thing which is judicious being done, without success, we are not, there- 
fore, to recede from our plan, while we still entertain the same views as 
we did at first (52, ibid). 



the remedy (lY, sect. II). The sickness which arises from repletion is 
cured by evacuation ; and that which arises from evacuation, by reple- 



THE DOCTRINE OF PURGATION. 11 

lY. Some diseases accord hetter with some constitutions than others / . Prediapo- 

and this also obtains with certain ages, as connected with season, climate conrtuutionf 

and aliment (3, sect. III). In the various seasons, if cold and heat fre- cfimatrS 

quentlv alternate with each other, we must look forward to autumnal f*^,^^; cia.np,Q 

^. - . ' of tempera- 

d^sea^es (4, ibid). ture. 



18. Those suifering from phthisis should avoid vomits (8, sect. lY). 



emetics inju- 



19. The melancholic should be copiously evacuated downwards ; and, Purgatives 
from the same principle of reasoning, those of a contrary temperament where to be 
should be differently treated (9 sect. TV). "''^• 



20. Sound Doctrine. — In very acute affection, attended with turg- Acute dis- 
escence, purgatives are immediately to be used ; to procrastinate here wuhouTTl 
is dangerous (10, sect. lY). ^'^y- 

21. Those who are tormented with severe griping s, pains about ^i^^*^*^^ 
the umbilicus., and in the region of the loins^ and who are neither purgatives 
relieved by purgatives, or any other means, usually fall into tympanites 
(11, sect. lY). 



useful. 



22. If there be pain immediately above or below the diaphragm^ plint^yfm- 
the former demands vomiting, the latter purging (18, sect. lY). iting and 

23. Those who, during the operation of purgatives, have no thirst, degree of 
ought to be purged until thirst be induced (19, sect. lY). purging. 

24. JF*ain in the lower region of the abdomen., with griping and ach- paAn in 
ing of the knees, unattended with fever, indicate the necessity of pur- f^pJr^aS"" 

gativeS (20, sect. lY). necessary. 

25. Darh-Golored dejections., resembling black blood, coming on svacua- 
spontaneously, either with or without fever, are very unfavorable ; and J^f* ^^^^^' 
the more so if the color of these dejections become, with their continu- 
ance, still more depraved ; but if the evacuations assume a more healthy 
complexion, or, if their darh color be the effect of purgatives, less evil is 

to be apprehended (21, sect. lY). 

26. The expectoration of blood, how small soever in quantity, is Evacuation 
injurious; but the evac^cation of black blood downwards is (frequently) eJen^Hfcha- 
advantageous (25, sect. lY). racter. 

27. With those who are deaf a coming on of bilious evacuations Dea/ness, 
generally removes it (28, sect. lY). evacuations 

28. If, in those recovering from indisposition, there occur any local p^.^ , 
pain, it foreshows the formation of an abscess (32, sect. lYV tom of ab- 

•^ '^ . \ ^ / scesses. 

29. From whatsoever part of the body sweat breaks forth, it fore- sv^eatsnnd 
shows a determination of the disease to that part (38, sect. IY)r ■^«"^> ^y^p- 



12 THE DOCTRINE OF PURGATION. 

tomatic of Tu wliatevci* part of tlie body lieat or cold arises there the disease 

disease. iiuli- , . ii'/oa n • i\ " 

cate the ne- SeatS itselt (^o9, ibui). 

?«r!/af?o«. W]iere there occur alternate changes of cold and heat, and the com- 

plexion nnder2;oes various changes of color, we may predict extended 
illness (40, ibid). 

Profuse sweats, during sleep, without any manifest local affection, 
may arise from a too plentiful diet ; but if they take place notwith- 
standing the observance of a frugal regimen, it shows the necessity of 
evacuation (41, ibid). 

Ahscef!sesi>^^ 30. In fcvcr, where abscesses have not been dispersed during the 
be purged" primarv stages of the disease, they foreshow extended illness (51 
sect. It). 

Fever, in- 31, When, witli cxistiug fever, a thick, gummy, scant urine is fol- 
the*uiine. ^ lowcd by a thin and copious discharge, it is beneficial ; but it is the 
more so, when, at the commencement of disease, or a little time after, 
the urine deposits a sediment (69, sect. lY). 

pfegnfnir^ ^^' ^ith pregnant women, venesection produces abortion^ especially 
causes abor- -f ggstatiou bc far advauccd (31, sect. Y). 



Brandreth's Pills are safe at every period of gestation with the generality of females. 
Irr&gxilar t-vit !• i -t i • ^ 

memtrua- 33. Discolorcd and UTe2:ular menses indicate the necessity oi pureja- 

^io?? requires . ,^^ -vt-s ^ ./ x o 

purgation. tlVCS (OO, SCCt. V j. 

Tiumors,^^ 34. Tumovs which have a soft feel are beneficial ; those which are 
malignant, hard and callous are unfavorable (6Y, sec. Y). 

Dropsy, 35, Jn dropsv, if the water pass off" into the intestines, by means of 

purgation , . r\ a- ^ /^ a ^ tttn 

the cure. the veius, the disease ceases (14 sec. V I). 

Purgation brings it to the intestines and so causes the water to be evacuated. 
Diseases of 



36. Diarrhea supervening in ophthalmia is beneficial (lY, sect. YI). 
^Fu%a^on. Pai7is of the eyes are relieved by pure urine, bathing, fomentation, 

venesection, and purging (31, sect. YI). 



Fever the 37. Paius in the hypochondrium, unattended with inflammation, are 
naturaicure. relieved by fcvcr (40, sect. YI). 

Effects of 3S- Long -continued dysentery, supervening in affections of the spleen, 
'uf ation induccs either dropsy or lientery, and consequent death (43, sect. YI). 

Purging in 39. Thosc witli whom purgativcs .agree should have recourse to 
Spring. i\^Qn^ in the spring (4Y, sect. YI). 



wheninflam- 40. Thosc attacked with the gout are entirely freed of it in forty 
purgMaway. days after the subsidence of the inflammation (49, sect. YI). 



More effects 41. lu atrabilious affections the translation of the humors to various 
purgauon^ parts has a tendency to produce the following diseases: apoplexy, 



mania, co'avulsion and hlindness (56, sect. YI). 



THE DOCTRINE OF PURGATION. 



13 



42. When a serous collection, attended with pain, takes place be- Accmrmia- 
tween the abdomen and diaphragm, without its having an issue in either inSines re* 
cavity, if the fluid be drawn out of the body by means of the veins, the ti'on^^^^^^ 
disorder ceases (54, sect. YII ; vide Aph. 14, sect. YI). 

43. Excessive perspiration, cold or hot, continually going on, is in- -s-M^m^— in- 
dicative of redundant moisture within ; we ought, therefore, to evacuate aISV^^ccS- 
it from the system either by vomiting, if the patient be strong, or by c^re^^Pur- 
purgation if he be weak (61,' sect. YII). games. 



44. He should attend to the urinary discharge in order to ascertain 
whether it be conformable to what takes place in health ; in proportion 
,as it departs from the healthy state is the severity of the disease, and 



{Q6, sect. YII). 



If, on suffering the urine to remain, without disturbing it, we ob- 
serve a deposit resembling sawdust, the greater or less quantity of this 
deposit is indicative of the severity or mildness of the disease ; in either 
case, it is necessary to have recourse to jpv/rgatives i in proportion as we 
neglect these, for a nutritive regimen, will be the augmentation of the 
disease (67, sect. YII). 



The urine 
a criterion of 
health or dis- 
ease — its tur- 
bid condition 
indicative of 



46. In continued fever, the expectoration of a livid, bloody, bilious, Conunued 

or foetid matter, is alike unfavorable ; but, if the expectoration be good, rinS^I^ url- 

and in due season, it is favorable. The same may be said of the alvine ^ulrJlarly 

and urinary discharges ; fm^thermore, any excrementitious matter re- and thor- 

maining in the system, and not coming away with the evacuations, qSeZ ^^ 
proves injurious (69, sect. YII ; vide Aph. 12, sect. II). 



HippocEATEs, the genuine works of. Transl. hy Francis Adams, LL.D., 
and f Tinted for the Sydenham Society. 2 vols. London, 1849. 



46. Medicine is, of all arts, the most noble ; but, owing to the igno- Medical 
ranee of those who practice it, and of those who inconsiderately form a ^s^ora^ce. 
judgment of them, it is at present far behind all the other arts (The 

Law, p. 784, vol. I). 

47. When nature opposes, everything else is in vain. Nature is the Nature. 
physician of diseases (p. 102, vol. I). 



The phy- 
sician's spe- 
cial object. 



48. The physician must have his special object in view with regard 
to diseases, namely : to do good or to do no harm. The art consists in 
three things : the disease, the patient, and the physician. 

The physician is the servant of nature, and the patient must combat The ser- 
the disease along with the physician (Epidemics, Book 1, §5, p. 360, IT/ ""^ """^ 
vol. II). 



49. Gentle purging of the bowels agrees with most ulcers, and in uicet-s. 
wounds of the head, belly, or joints, where there is danger of gangrene, uy.^^* ^^^' 
in such as require sutures, in phagediac, spreading, and in otherwise 
inveterate ulcers (On Ulcers, pp. 796-7, vol. II). 



14 THE DOCTRINE OF PURGATION. 

Purge in 50. Disordei's arising from repletion are removed bj evacuation (On 
d£m^. the jS^ature of Man, p. 262, vol. I ; Aphor, 22, sect. II). 

jf>r<.r«pass 51. AYhen the discharges become thicker, more concocted, and are 
STe^^/u^SS ft'^ed from all acrimony, tlien the fevers pass awaj, and the other symp- 
"r^ed'^^'^' ^^^^^^^ which annoycd the patient (Ancient Medicine, p. 174, vol. I). 



52. When there is an overflow of the bitter principle, which we call 
fui^^fijmp'- yellow bile, what anxiety, burning heat, and loss of strength prevail ! 
*moted by ^^^^ if relicvcd from it, either by being purged spontaneously, or by 
artSii ^"^ iiieans of medicine seasmiahly administered^ the patient is decidedly re- 
purgation, licvcd of the paiu and heat. But while these things float on the stomach 
t^hejjQiytrue i^^j^concocted and undigested, no contrivance could make the pains and 
fever cease ; and where there are acidities of an acrid and eruginous 
character, what varieties of frenzy, gnawing pains in the bowels and 
chest, and inquietude prevail ! And these do not cease until the acid- 
ities be purged away (p. 174, vol. I, ibid.) 

The bad 53. The coction, change, attenuation, and thickening into the form 
^TOrious ° of humors, take place through many and various forms (p. 174, ibid.) 

kinds. 

^ 54. We must pur2:e and move such humors as are unconcocted (p. 

What to ^„^ , -rT\ -t^ & vr 

pwge. TOd, vol. 11). 



Purge until 
evacuations 



55. The evacuations are not to be judged of by their quantity, but 

whether they be such as they should be, and how they are borne. And 

event?fai2t- whcu propcr to Carry the evacuation to " liquidium animi " (faintness), 

^^' this, also, should be done, provided the patient can support it (p. 704, 

vol. I ; Aph. 23, sect. I). 

Note by Editor. — To give the patient an opportunity of doing so, have gruel or light 
broth ready for him to sip a little at a time. Intelligent nursing must go alongside of the 
purgative method, then success is moderately certain. 

Purgative ^^' ^^ *^^ matters which are purged be such as should be purged, 
a^iom. the evacuation is beneflcial (p. 704, vol. II ; Aph. 2, sect. I). 

Effects of ^'^' Bodies not properly cleansed, the more you nourish, the more 

What remains in diseases, after the crises is past, is apt to produce 
relapses (p. 707, vol. II ; Aph. 12, sect. II). 



Purgative 58. In purging we should bring away such matters from the body 
as it would be advantageous had they come away spontaneously (p. 723, 
vol. II). 



axc/iom 



59. Our Doctrine.— h\. very acute disease, purge on the first day, for 
eanen. Purge it IS a vcry bad thmg to procrastmate m such cases (p. 724, vol. 11 ; 
Aph. 10, sect. lY). 



Acfute Die- 
',ase 
only. 



THE DOCTEINE OF PURGATION. 



15 



60. In convalescents from diseases, if any parts be pained, there are 
deposits being formed 
to the iUness, there the disease fixes (p. Y28, vol. II 



Deposits 

But if any part be "in a painful state prevjous }ZT jZrga- 



Aph. 32, sect. lY). 



61. N". B. — The translator says : '' Hippocrates was strictly the phy- ExpeHmee 
sician of experience and common sense." and comwow 



62. JSTature finds out ways for herself without consultation ; nature, Natmr&s 
untaught and without learning, does what is needful (Epidem., lib. YI, '^S^ *" 
5. 5, Edinb. ed.) 



63. Ascl&piades^ about 100 years B. C, the earliest hydropathist, con- 
trived easy methods, and such_ones as any one might nse without the 
help (and cost) of a physician. This made them very acceptable, and 
Plinius (Lib. XXYI, Cap. Ill, p. 444) writes about him the follow- 
ing : " Five things of most common benefit he held to : Occasional ab- 
stinence from meat, at other times from wine, the use of the flesh-brush, 
the exercise of walking and of riding ; which, as every one believed he 
could prescribe for himself such remedies as these, and as it is natural 
to wish those things true that are most easy, made all people flock unto 
him as to one sent from heaven." He disapproved of the then popular 
practice of frequently using violent emetics and purgatives, for which he 
substituted the clyster as the safest way to obtain — what appeared to 
him the first measure to be taken in most of diseases — evacuation of the 
howels. His method of employing siiruple remedies^ for the sake of their 
safety and innocence, but producing the effect wished for, and his extra- 
ordinary skill in a quick diagnostic, gained him a fame that almost 
overthrew the old heroic method of the then practitioners of Rome, as 
we read of him in Plinius, XXYI, 8 ; Celsus, III, 4, II, 6, Carlius 
Aurelianns, Morb. acert., I, 15 ; Aquilejus, Florid., lY, 362 ; Plinius, 
Hist. Nat., YII, 37; and'Saleh Ben Balah, Chap. 12. 

He recommended clysters of cold water for the aged, and for persons 
troubled with stone or gravel, for females having falling or other affec- 
tions of the womb, and in all kidney affections when the bowels require 
moving. 



Simple and 
safe purga- 
tive remer 
dies^ THE 

MEDICINE OF 
THE PEOPLE, 

combined 

with whole- 
some food^ 
personal 
cleanliness, 
temperance, 
and exercise 
of the 'body 
preserve 
health and 
cwre dis- 
ease. ^ 



Water clys- 
ters for the 
aged. 



64. Rhazes or Rasis, on Pestilence^ written about 890 at Corduha- 
This book of Rhazes' is a curious and valuable record of the Arabian 
practice in small-pox and measles. The best edition in Arabic and Latin 
is that by I. Channing, London, 1Y66. The doctor's theory is that of 
fermentation, and his practice is of the cooling kind, together withyr^^ 
evacuation of the howels. 

There is also another translation of this book in English from the 
Arabic text by Dr. Greenhill (8vo., London, 184Y). 



Small-pox 
and measles 
—powerful 
purges. 



65. AviCENNA, or Abu Ali Al Hosaln Ehn Ahdallah Ehn Sina^ who intestinal 



was born in the year of the hegira 370 or 987 A. D., t\\Q first writer who ^^l^J'^Zi~ 
formed a complete system of medicine^ was of opinion that evacuation of evacuation 
the howels., actively and perseveringly employed, was the main principle 
in the cure of disease. He was, however, more in favor of clysters than 



the cure. 



16 THE DOCTRINE OF PURGATION. 

of internal purgative remedies, not considering that that method of pur- 
gation, often repeated in a proportionately short space of time, bj its 
mechanical action, must prove injurious, causing ulcerations in the in- 
coiic. testinal canal. Thus, when subject to a severe attack of colic, he took 
cigfht clysters in one day, which producing ulcers in the intestines, toge- 
tJier with an epilepsy, a consequence of intemperance and sensuality, 
that had weakened his vital forces, thus causing his early death. Of 
his numerous books, said to be more than one hundred, his " CanonJ^ 
and some tracts were printed in 1593 in Rome. 

Parey, Ambrose, M. D., Physician to Henry III., King of France 
and Poland. Paris, 1579. Transl. TJios. Johnson, M. D. Lon- 
don, 1634. 

ExpeHence io^. Although iudccd we cannot deny but that experience has much 
\hQscience. profited this art, as it has and does many others. For, as men per- 
ceived that some things were profitable, some unprofitable for this or 
that disease, they set it down, and so by diligent observation and mark- 
ing of singularities, they established universal and certain precepts, and 
so brought it into an art (Pref.) 

Disease 67. There is no disease which arises not from some one, or the mix- 

it^ofThe^^' ture of more, humors. Which thing Hippocrates imderstanding, 
blood. wrote every creature to be either sick or well according to the condition 

of the humors. And certainly all putrid fevers proceed from the 
^putrefaction of humors. N^or do any acknowledge any other original 
and distinctive of the difi*erences of abscesses or tumors ^ neither do 
ulcerated, broken, or otherwise wounded members hope for the restora- 
Purgatwes tiou of Continuity, from other than from the sweet falling down of 
removemor- humors to the wouudcd part, which is the cause that often in the cure 
^vorTtfe^ of these aifects. The physicians are necessarily busied in tempering the 
blood. blood ; that is, bringing to a mediocrity the humors composing the mass 

of the blood, if they at any time oifend in quantity or quality. For if 
anything abound or digress from the wonted temper, none of the accus- 
tomed functions will be well performed. . . . Purging corrects and 
draws away the vicious quality of the hlood (pp. 11, 12; cf Hippoc. 29, 
30). 

hmlhTZ^ 68. But with the blood at one and the same time, all the humors 
the blood in are made, whether alimentary or excrementitious. Therefore the blood, 
\tate!^^ that it may perform its office, that is, the faculty of nutrition, must 

necessarily be purged and cleansed from the excrementitious humors. 

. . . The parts of which the blood is composed ought to be tempered 

and mixed among themselves in a certain proportion, which remaining, 

health remains, hut violated^, disease follows (p. 12). 

Dia/rrhm 69. Evjacuation is no other thing than the expulsion or effusion of 
ing. Thenat- humors which are troublesome, either in quantity or quality. Of evac- 
S morbid°" nations some are universal, which expel superfluous humors from the 
matter must wholc body ; such are purging, vomiting, perspiration, sweats ; some 



THE DOCTRINE OF PURGATION. 17 

particular, which are performed only to evacuate one part, as the be assisted 
stomach by vomiting and stools, the guts by stools, the liver and spleen 
by urine and ordure. These evacuations are sometimes j^erformed hy 
nature ^freeing itself of that which is troublesome to it ; otherwhiles by 
the art of the physician in imitation of nature (p. 3Y). 

70. The causes of congestion are two principally, as the weakness of froS* morbid 
the concoctive faculty^ which resides in the part, by which the assimila- tfo^nJ^'^'J;^^ 
tion into the substance of the part of the nourishment flowing to it hyPurga- 
is frustrated, and the weakness of the expulsive faculty / for while the ^*^^* 
part cannot expel superfluities, their quantity continually increases (p. 
250). Those humors which are rebellious rather offend in quality than 
in quantity, and undergo the divers forms of things dissenting from 
nature, which are joined by no similitude or afiinity with things natural 
(p. 252). A convenient diet aiid purging must be used ; ill humors are 
amended by diet and purging (p. 253). 

Yl. Cancer. — The antecedent cause depends upon the default of fr^mlmpur- 
irregular diet, generating and heaping up gross and feculent blood / by f|^^°J *^® 
the morbific affection of the liver disposed to the generation of that 
blood ; by the infirmity or weakness of the spleen in attracting and 
purging the blood ; by the suppression of the courses or hemorrhoides, 
or any such accustomed evacuation. The conjunct cause is that gross 
and melancholic humor sticking and shut up in the affected part, as in 
a strait (pp. 279-80). 

72. The glands at the root of the tongue are very subject to inflam- cmetTpSr- 
mations and swelling from crude, viscous humors. Swallowing is pain- ffauon and 
ful to the patient, and commonly he has a fever. Often the neighboring pUcaSons.^^ 
muscles of the throat and neck are so swollen together with these glan- 
dules that the passage of air and breath is stopped and the patient 
strangled. We resist this imminent danger by purging, by applying 
cupping-glasses to the neck and shoulders, by frictions and ligatures of 

the extreme parts, and by washing and gargling the mouth and throat 
with astringent gargarisms (pp. 293, 94). 

73. The dropsy is a tumor against nature by the abundance of i>ropsy- 
waterish humors, of flatulences, or of phlegm, gathered one while in 

all the habit of the body, otherwhiles in some part, and that especially 
in tlie capacity of the belly, between the peritoneum and the entrails. 
From this distinction of places and matters there arise divers hirids of 
dropsies. . . . Yet they all arise from the same cause ; that is, the weak- 
ness or defect of the altering or concocting faculties, especially of the 
liver, which has been caused by a scyrrhus, or any great distemper 
(pp. 299, 300). 



74. The beginning of the cure must be with gentle and mild medi- p^^^gatvo^I 
cines ; neither must we come to a paracentesis, unless we have for- and diuret- 
merly used and tried these ; therefore, it shall be the part of the 
physician to prescribe a drying diet, and such medicines as carry away 
water, both by stool and unf%ne (p. 301). 



18 THE DOCTRINE OF PURGATION. 

from*^"orV- ^•^- Tetunus — Caiises. — Abundance of humors causes repletion; 

meutitious dulling tlic bodj by immoderate eating and drinking, and omission of 

matters. gxercisc or any accustomed evacuation, as suppression of the hemor- 

rhoides and courses, for hence are such like excrementitious hitmors 

drawn into the nerves with which they, being replete and filled, are 

dilated more than is fit, whence, necessarily becoming more short, they 

pi^^tiv^I siiifer convulsion. ... It is cured by discussing and evacuating remedies, 

^'m'ldiciier^ as purging, digestive local medicines, exercise, frictions, and other things 

&c. ' which may consume the superfluous excrementitious humors that possess 

the substance of the nerves and habit of the body (pp. 329, 30). 

Note. — Allcock's Porous Plasters applied along the spine from neck to os sacrum, and 
Brandreth's Pills two every two hours, is good treatment for lockjaw. 

from^obftru ^^' ^^^V' — ^hc causc are humors obstructing one of the ventricles 

tion by mor- of the brain, or one side of the spinal marrow, so that the animal 
bid matter. £g^(3^^;[|-^ — ^^Q workcr of sense and motion — cannot, by the nerves, come 

to the part to perform its action (p. 332). 
Purgation In the curc of the palsy we must not attempt anything, unless we 

^'^^^' have first used general remedies, diet and purging, all which care lies 

upon the learned and prudent physician (p. 333). 

. 77. Erysipelas. — The cure of such an effect must be performed by 

Purgef^Sii two mcaus ; that is, evacuation and cooling with humectation. If bile 
do not bleed. ^\q^q causc this tumor, we must easily be induced to let blood, hut we 
must purge him with medicine evacuating hile (p. 353). 

Note. — Bleeding must never be resorted to in Erysipelas ; it is dangerous, never does 
any good, and is certain to retard the cure. 

78. The cure of gangrene, caused by the too plentiful and violent 
T^lu^rS- defluxion of humors suffocating the native heat, by reason of great 
mustb^^a- phlegmons, is performed by evacuating and drying up the humors, 
c%ated. which putrify by delay and collection in the part (p. 456). ... If the 

body be plethoric, or full of ill humors, you must purge (p. 455). 

79. An ulcer has one, and that a simple indication, that is, exsicca- 
quS?Says ^^^^- • • • before you do anything about the ulcer, you must first use 
pv/rgation, general means ; for in Galen's opinion, if the whole body require prepa- 

nai appUca- ratiou, that must be done first, for in some ulcers ^purgation alone will be 
*^°"^' sufficient (p. 470). . . . Dry ulcers you shall correct by humeating 

medicines, as fomenting it with warm water, &c., but always you must 
first purge. . . . Then you must have recourse to refrigerent things 

(p. 471). 

Note. — The Gum Elimi Universal Cerate should be procured. We can recommend it. 
It contains no grease or oil, but is a vegetable production, and very useful in all affections 
of the skin ; as an application to a felon or otherwise it is superior to bread or liuseed meal 
as a poultice. 

^^^y^OTo- 80. Ophthalmia can proceed from different causes, external and 
eyes. Pm-ge internal, producing the settling of humors to the eye. The evacuations 



THE DOCTRINE OF PURGATION. 19 

of the matter flowing into the eye, shall be performed hj purging medi- 
cines, cupping the neck and shoulders with scarification or without \ 
and lastly by frictions, as the physician shall think it fit (p. 645). 

Allcock's Porous Plasters are superior, applied to back and shoulders, to cupping, scar- 
ifications or frictions. 



81. The Diabetes is a disease wherein presently, after one has drunk, mabeten. 
the urine is made in great plenty, by the dissolution of the retentive fac- morMd mat- 
ulty of the veins, and the deprivation or immoderation of the attractive cluresTn- 
faculty. The causes are the inflammation of the liver, lungs, spleen, flammation. 
but especially of the kidneys and bladder. . . . For the cure of so 
great a disease, the matter must he purged which causes or feeds the 
inflammation (p. 688). 



82. "Whenever the guts, being obstructed or otherwise affected, the coUe. 
excrements are hindered from passing forth, if the fault be in the small and^physfoi- 
guts, the effect is termed " Yoloutus, Iteos, or miserere mei ;" but if it ^gy. 
be in the greater guts, it is called the " colic," from the part affected, 
which is the colon. Therefore Avicen rightly defines the colic as "a 
pain in the guts, wherein the excrements are difiicultly evacuated by 
the fundament." Taulus Eleginata reduces all the causes of colic to 
four heads, to wit : to the grossness or toughness of the humors impact 
in the coats of the guts ; flatulencies hindered from passage forth ; 
inflammation of the guts ; and, lastly, the collection of acrid and bit- 
ing humors. . . . Over-eating and taking in of nourishments that do 
net agree with each other, or with the constitution of the body, produce 
crudity and obstruction, and at length the collection of flatulencies, 
whereon a tensive pain ensues. . . By the use of crude fruits and too 
cold drinks the stomach and guts are refrigerated, and the humors and 
excrements therein contained are congealed, and, as it were, burned 
up (p. 689). ... 



83. There is also another cause of the colic which is not so common, Ente-oceu. 
to wit, the twininai: of the e:uts, that is, when they are so twined, folded cure by ^-wr- 
and doubled, that the excrements, as it were, bound m their knots, can- 
not be expelled.* . . . The colic is cured, the humors heing first atten- 
uated and diffused, and at length evacuated hy medicines taken hy the 
mouth and otherwise (pp. 690, 91). 

* Some sweet oil, followed hy a dose of BrandretNs Fills, is the simple remedy by which 
to relieve such painful state of the bowels. Also, clysters of water, about summer heat, 
should be given. 



84 Arthritis, or Gout, is a disease occupying and harming the sub- oo^'t. 
stance of the joints by the falling down and collection of a virulent ^^^^ ^^i^ls^a 
matter and humors. When there is a great abundance of humors in a general dis- 
body, and the patient leads a sedentary life, not some one, but all the festingitseif 
joints of the body are at once troubled with the gout (p. ()9Y). locationr' 



20 THE DOCTEINE OF PURGATION. 

85. The causes of gont are unprofitable humors which are generated 
^emp""^' and heaped up in the body, and in the process of time acquire a virulent 
wnei^fi'tep iii^lignit.Y- Sucli huuiors arise from an inordinate diet : they offend in 
tcant of ea^- feediuo: wlio Cat niucli meat, drink strona; wine, sleep presently after 
duceaVcMMi- their meals, and use little exercise. For hence a fullness and obstruc- 
morbid" mat- tiou of the vesscls, cruditics, and the increase of excrements, especially 
^^^- serous, and, if they flow down into the joints, without doubt they 

cause this disease. Besides, also, the suppression of excretions accus- 
tomed to be voided at certain times. 

. . . Those who recover of great and long diseases, unless they be 

fully and perfectly purged, these humors falling into the joints, which 

Imperfect are the relics of the disease, make them become gouty. The humor 

m"diseaSs iuipact and shut up in the capacities and cavities of the joints, it cannot 

^weTa&ut ^^ easily digested and resolved. The humor then causes pain by reason 

of distention or solution of continuity, distemper, and besides the viru- 

lency and malignity which it acquires. The concourse of flatulencies 

and hiiiderance of transpiration increase the morbific painful distention 

in the membranes, tendons, ligaments and other bodies of which the 

joints consist (p. 700). 



Cure: 



86. To cure the gout there are two indications : the first is the evacu- 
Pw^7tion, ation and alteration of the jpeccant humors^ the other the strengthening 
had1^^sp?in| <^f the weak joints, accompanied by a fit diet. ... A fit time for purg- 
and autumn, jng is the Spring and autumn, because gouts reign chiefly in these 
seasons (p. 704 ; cf. Hipp. Aph. 55, S. YI). 

GOLDEN WOEDS. 



Purgation 



87. ISTow, it is convenient that the purge be stronger than ordinary, 

for if it should be too weak it will stir up the humors, but not carry 

musTbe""""" them away, and they thus agitated will fall into the pained and weak 

^gradually joiuts, and causc the gout to increase. . . . The fever accompanying 

B^ures^fso ^^^ S^^^ easily becomes continual, unless the belly being first gently 

the incident purged, uature be freed by stronger pu|ges of the troublesome burden 

^ilTreat- ** of the humors. . . . Seeing that physic is the addition of that which 

^^through- "i^cf^ture wants, and the talcing away of those things that are superfluous, 

c^urse^ofthe ^^^ ^^^ 9^^^ ^^ ^ diseasc that has its essence f7'om the abounding 

disease. humoT, ccrtaiuly, without the evacuation of them, we cannot hope to 

cure either it or the pain which accompanies it. Metrius, in his treatise 

of the gout, writes, that it must be cured by purging, used not only in 

the declination hut also in the height of the disease, which we have 

POUND TRUE BY EXPERIENCE (p. 710 ; cf. Hipp. Aph. 23, scct. I, and 

Aph. 8, sect. II.) 



Sciatica. 88. Sciatica. — Strorig purgatives are here also useful, such as used in 

pu^es and phlegmatic causes. Often vomitings do not only evacuate the humors, 
but also make a revulsion (p. 720). 

89. The heat or scalding of the water arises from repletion, inanition 
or contagion. That from repletion proceeds from too great abundance 



THE DOCTRINE OF PURGATION. 



21 



of blood, causing tension and heat in the urinary parts, whence proceeds 
the inflammation of them and the genital parts. . . . Purgings are cur^y^l 
convenient, and a diet abstaining from heating articles, together with ff<^f^on. 
cooling external applications (pp. 738, 740). 

90. buboes, or Swellings in the Groins. — The matter of these for the Buboes 
most part is abundance of cold, tough cmd viscous humors, as you may Evacuate the 
gather from the hardness and whiteness of the tumor, the poverty of the pm^ation. 
pain and contumacy of cure ; which also is a reason why the virulency 

of this disease may be thought to fasten itself in a phlegmatic humor. 
The cure shall be performed by detergent medicines, and the humor evac- 
uated hy a jpurging medicine (p. 746). 

91. Tetters, Bing-worms or Chops. — For general remedies, the distem- 
per of the liver and habit of the body must be corrected. This may be T^**^'>^ 
done by diet conveniently appointed, by purging and alterative medi- kT.^'pur^' 
cines, as they acquire their matter from salt phlegm or adust bile 

(p. 754). 



92. N"ow, the Small-Pox is pustules, and the Measles spots, which 
arise in the top of the shin, by reason of the impurity of the corrupt blood 
«ent there by the force of nature (p. 757). You must neither purge nor 
draw blood, the disease increasing or being at its height, unless perad- 
venture there be a great plentitude, or else the disease complicate with 
others, as with a pleurisy, inflammation of the eyes, or a squinancy* which 
require it, lest the motion of nature should be disturbed, but you shall 
think it sufficient to loose the belly with a gentle clyster ; but when the 
height of the disease is over, you may with cassia, or some stronger 
medicine, evacuate part of the humors and the relics of the disease 
(p. 759). 

* Quinsy. 

Parey was plainly unacquainted with the good effect of purgation in the early stao-e of 
Small-Pox, .when the purgative employed was efficient yet innocent. 

In many thousand cases the Brandreth Pills have been administered, more or less dur- 
ing the course of Small-Pox, and with evident advantage in every case. 

These Pills are very useful where patients cannot obtain a doctor, and there are 
thousands of towns in the United States where there is not a medical man within one hund- 
red miles. 

The following letter from Daniel Bissell, of l^ewcomb, Essex County, JSTew York, who 
was supervisor of the town for twenty years, may be important. I consider it my duty to 
publish it here : 

MR. BISSELL' S LETTER. 

Four persons cured of Small-Pox hy purging with JBrandreth's Pills. 

Newcomb, Essex Co., K Y., Sept. 13th, 1861. 
Doctor Benjamin Brandreth, New York. 

Dear Sir : In our family we have used your excellent Pills for several years, and have 
found them to be a never-failing remedy in mild and severe cases of sickness, but their full 
value we did not fully appreciate until last winter, when the Small-Pox visited so many fam- 
ilies in this and the surrounding towns. I was first attacked, and supposed I had a cold ; 
took four Pills and some warm drinks ; next day no better, took four more ; still no better, 
and my wife said I should take eight — did so, and then the SmaU-Pox began to show itself! 
On the fifth day took to my bed, and in less than four days was covered from head to foot 
with pustules. I continued to use the Pills daily, and took no other medicine whatever 



Small-Pox 



from impiir 
rity of the 
blood. 



The use of 
purgaUves. 



22 THE DOCTRINE OF PURGATION. 



except your Vegetable ITniversal Pills. The Pox was less than four days in coming to a 
head, and in about the sauio time they dried up. I began to attend some to my stock in 
about two weeks, but in three weeks I was attending to my regular farming business, having 
quite recovered my usual health. I took eighty Pills during my sickness, in doses of four 
to eight Pills, according to effect, being careful to procure two or three evacuations a day ; 
and "though covered from head to foot with the disease, yet it has not left a mark upon me, 
which is one of the benefits said certainly to be secured by the use of Brandreth's Pills. I 
and my fiimily found this to be so in our experience of their effects in this fell disease. 

My wife, well known as Aunt Polly for one hundred miles around us, was attacked with 
the disease about the time 1 was getting well of it. From the first she understood it was 
the Small-Pox, and prepared herself to combat its virulence by a free use of the Pills. In 
six days, and while confined to her bed, and scarcely able to move from excessive weakness, 
Bhe used twenty-six Pills, or a little over an average of four Pills per day. And what was 
the consequence of this continued purging with Brandreth's Pills ? On Tuesday she was 
obliged to take to her bed; by Friday the pustules were all filled; and by the following 
Tuesday she had dressed herself! and in one week after was attending to her regular house- 
hold duties, to the astonishment of all her neighbors. One fact deserves notice : although 
she was covered with the disease, yet it has left no mark whatever on her skin, which bears 
no evidence of the awful ordeal it has passed under. 

Mrs. Wetherbee, my daughter, her husband, and their only child, were all stricken down 
by the Small-Pox. Mrs. W. had it light, and only some seven pustules came out. She used 
thirty Pills in fourteen days. Alonzo, her husband, had a severe attack, and took the Pills 
all through it, the number not noted. They both recovered in fourteen days from its com- 
mencement. Their little boy, Daniel, about fifteen months old, had the disease badly; we 
had little hope to save him. He was covered from head to feet ; he was like a huge scab; 
and for days he lay insensible. We all supposed he would die — that nothing could save 
him. His bowels had been confined for several days, and my wife said this must be reme- 
died — that perhaps if the boy could be purged he might revive. She read over yours and 
Dr. Lull's experience, and gave him one Pill, crushed, in some warm water. The Pill pro- 
duced no effect, but she was impressed with your remarks upon the necessity and import- 
ance of having the bowels purged in Small-Pox, and in all serious sickness whatever ; so she 
gave him another Pill. Still no effect. She then pounded three Pills, and added warm 
water, and gave them to the boy at once. Still no effect. There the little sufferer lay with- 
out motion, except the rapid breathing and peculiar signs of speedy dissolution evident to 
all. If he died, it would be said he might have got well had his bowels only been opened, 
and we then commenced to give him three Pills in two hours, or at the rate of one and one- 
half per hour. When this child of fifteen months had taken thirteen Pills, they operated, 
and most fully. The stools were black as pitch, and most offensive. Every one was satisfied 
that it was death and mortified matter which the Pills had brought away, and that the Pills 
had saved another life, through the Providence of God. 

In an hour after the Pills commenced to operate he began to revive, and took some re- 
freshment. He continued to improve until he got well. He is not marked with the disease. 
It seems proper to state that, though it took thirteen Pills to open his bowels, yet two days 
after he had a full natural evacuation without medicine, and his bowels have been regular 
up to this day, which is nearly nine months from the time of his sickness, nor has he used a 
Pill since. He is as lively, intelligent, and healthy a boy as can be seen. His parents will 
ever be grateful to you, and they and myself and wife desire you to publish this letter, 
which, if need be, can be certified to by all the residents of this and the adjoining towns. 
I am, respectfully, yours, 

DANIEL BISSELL, 
** For many years Supervisor of the Town. 

We certify to the truth of the above. (Signed) — ^Polly Bissell ; Alonzo Wetherbee; 
Mart Wetherbee; Russell Root, Postmaster, Schroon River; Erastus P. Root; Thomas 
R. Carey, Justice of the Peace, Town of Long Lake ; Cyrus H, Kellogg, Supervisor of Town 
of Long Lake, 1860; William Wood, Commissioner of Roads, Town of Long Lake ; Josiah 
Wood, Raquette Lake ; Wm. Helms, Forked Lake ; W. H. Plumbley, Forked Lake ; Amos 
Hough, Forked Lake ; Ezekiel Palmer, Long Lake Hotel. 

ANOTHER CURE OF SMALL-POX. 

HOW TWO MEN WERE TREATED. 

I may also in this connection introduce the following statement of Joseph Daily, of No. 4 
Union Square, New York : 

Joseph Malone and Henry Downs, acquaintances, on the same day were taken sick. 
Malone took ten Pills of Brandreth's ; next day, feeling no better, he took six more : still 
feeling no better, he took four more the third day ; fourth day better, got up and dressed 
himself, when, to his great astonishment, he observed large pimples on his face ; it was in 



Worms 
from Discid 



THE DOCTRINE OF PURGATION. 23 

fact covered with Pox. Upon a further examination he found that they were coming out all 
over him; even the soles of his feet were full. Malone used the Pills more or less every day 
until he was perfectly recovered, which was within three weeks from the first day of sick- 
ness, when he was again at his business. Though covered from head to foot with the Pox 
they did not leave a mark behind. 

Henry Downs when taken sick called in a doctor, who discovered on the third day the 
true nature of the disease, and sent his patient to the Small-Pox Hospital on Blackwell's 
Island. There he remained two months, and then was discharged cured. He lost an eye 
while in the Hospital, and was so marked that his nearest friends hardly knew him. These 
facts will bear the strictest investigation. 



WOEMS. 

93. A gross, viscid and crude humor is the. material cause of worms, 
which having got the beginning of corruption in the stomach, is quickly 
carried into the guts, and there it putrefies, having not acquired the '^hZmorr^at 
form of laudable chyle in the first concoction. This, for that it is viscid, inS Intes- 
tenaciously adheres to the guts, neither is it easily evacuated with the %^l^ ^^r^ 
other excrements ; therefore, by delay it further putrefies, and by the fl'a^*^^*- 
efficacy of heat, it turns into the matter and nourishment of worms 

(p. 765). In this disease there is but one indication, that is the casting 
out of the worms forth of the body, as being such that in their whole 
kind are against nature. . . . Now as such things breed of a putrid 
matter, the patient shall he purged, and the putrefaction repressed. . . . 
Oil of olives kills worms. ajst> so do all bitter things (p. Y67). 

Brandreth's Pills are infallible as a cure for worms, with or without olive oil. 

94. Leprosy proceeds from impurity of hlood. — You must understand 

that the cause of the leprosy by the retention of the superfmities, happens uatu'o^' 
because the corrupt blood is not evacuated, but regurgitates over the Leprosy— 
whole body, and corrupts the blood that should nourish all the members, iiJT orfhe 
wherefore the assimilative faculty cannot well assimilate by reason of uau'iSfm- 
the corruption and default of the juice, and thus, in conclusion, the ^Jlvilit Tts 
leprosy is caused. The antecedent causes are the humors disposed to relJnCTatiJn 
adustion and corruption into melancholy by torrid heat. . . . Galen (ad 
Glauconem, lib. 1, cap. 11.) defines it : " An effusion of troubled or gross 
blood into the veins and habit of the whole body " (pp. Y69, YO). A 
cooling diet and purging shall be prescribed to evacuate the impurity of 
the hlood and mitigate the heat of the liver (ibid. ; cf. 68 ; cf. Yl, 82, 93 ; 
Hippoc. 42, 60). 

95. Hydrophobia, — Such as have not their animal faculty as yet Hydropho- 
overcome by the malignity of the raging venom must have strong pur- ^purgatlvef 
gatives given them. For it is a part of extreme and dangerous madness A<w* ^^e-^^- 
to hope to overcome the cruel malignity of this poison already admitted ^*"^* 
into the bowels by gentle purging. . . Neither shall they let blood, lest sueding 
so the poison should be drawn further into the veins. But it is good ^<^^^Qe,rous. 
that the patient's body be soluble from the very first (p. 789). 

Note. — Brandreth's Pills, four every two hours, until twenty pills be taken, is the best 
means, and will hardly fail if resorted to in season. 



the 
nature 



24 THE DOCTRINE OF PURGATION. 

96. The general and natural causes oiihe plague are absolutely two, 
from '^^'^r- tliat is tlie tnfection of corrivpt air, and a prej>aration and fitness ojf' 
'^l^%€d)s- corrupt liumors to take that infection (p. 819). 

the bodv °^ Humors putrify either from fullness which breeds obstruction, or bj 
distemperate excess, or by admixture of corrupt matter (p. 820). 

97. I say that the pestilence does depend on the default of the air ; 
Abscesses this default, being drawn through the passages of the body, does at 

length pierce into the entrails, as we may understand by the abscesses 
that break out, by reason that nature using the strength of the expul- 
sive faculty, drives forth whatever is noisome and hurtful (p. 84:5V 

98. The physician must not let blood, for when nature is debilitated 
by this evacuation and the spirits, together with the hlood, exhausted, the 

Tcuu^^^^^ venomous air will soon pierce and be received into the empty body, 

where it exercises its tyranny to its utter destruction. ... If there be 

strong great fullness in the body, especially in the beginning, . . then it is 

^duiu ^pur^- lawful to purge strongly. ... If you call to mind the proper indica- 

ing saves, tions, purging shall seem necessary, and that must be prescribed as the 

case requires, rightly considering that the disease is sudden, and requires 

medicines that may with all speed drive out of the body the hurtful 

humor wherein the noisome quality does lurk and is hidden (pp. 846, 

47). 

99. Concussion of the Brain. — By a heavy blow or the like occasion, 
the veins and arteries of the^head may be broken. From hence pro- 

concussion cccds the afflux of blood running between the skull and membranes, or 
Purgation else betwccn the membranes and brain. The blood congealing there, 
causes vehement pain, and the eyes become blind, vomiting is caused, 
the mouth of the stomach suffering together with the brain, by reason 
of the nerves of the sixth conjugation, which run from the brain thither, 
and fi^om thence are spread all over the ventricle ; whence, becoming a 
partaker of the offense, it contracts itself, and is presently, as if it were, 
overturned ; whence first these things that are therein contained are 
expelled, and then such as may flow thither from the neighboring parts, 
as the liver and gall, from all which bile is first expelled (p. 351). 

Brandreth's Pills in these cases purge in from thirty to sixty minutes. 

100. To cure a l)rohen and dislocated hone is to restore it to its 
In frac- former figure and site ; that is, first to restore the bone to its place ; 

&07iesandaii sccoud, to bring it to stay, being so restored; third, to hinder the 
opIrdii!)ns increase of malign symptoms and accidents, or else if they happen to 

Sr'fhebiood temper and correct their malignity. . . . For this purpose we drive 
away the dsfluxion ready to fall down upon the part by medicines, repel- 
ling the humor and strengthening the part, or by appointing a good 
diet, hinder the begetting of excrements in the body, and divert them 
hy purging (pp. 565, ^'o). 

T^OTE. — The importance of purging and the reasons therefor are strongly presented by 
Ambrose Parey, and will have weight with sensible men, in or outside of uhe profession 



indicated. 



THE DOCTRINE OF PURGATION. 25 

Sanctoeius, M. D., Prof, of Physic at Venice ; Ars. de Statica medi- 
cina, Venice^ 1614. Aphorisms^ translated hy John Quincy, M. D. 
London, 1720 

101. If there daily he an addition of what is wanting, and a suhtrac- The great 
ticm of wha,t abounds, in due quantity and quality, lost health may he S?Sf ^* ^i 
restored, and the present preserved. (Aph. 1, sect. 1.) 



disorgani- 
zation and 
reorga/niza- 
tion. 



He only who knows how much and when the body does more or 
less insensibly perspire, will be able to discern when and what is to be 
added or taken away, either fm* the recovery or preservation of health 
(Aph. 3). 

IS'oTE. — Nature herself does all these things, provided we relieve the body by purgation ; 
for innocent purgatives take out no humors but those which are depraved. 

102. Insensihle perspiration is either made hy the pores of the body, 
which is all over perspirable, and covered with a skin like a net, or it is 
performed hv respiration through the mouth, which usually in the space '*io'>h tow it 

r> T . i 1 2 1 li' -\ r s. ^ y\ is performed. 

of one day amounts to about halt a pound (Aph. 5). 

Note. — Should either of these processes of the skin or the lungs be partially suspended, 
we have only to increase by purgation the activity of the bowels, this organ measurably 
taking upon itself their work, they partially resting the while ; then both lungs and skin 
will soon regain their healthy functions. 



Insensible 
persjnra- 



103. If the body increases beyond its usual weight without eating or gfauc me- 
drinking more than customary, there must either be a retention of the f^j^^amentS 
sensible excrements, or an abstraction of the perspirable matter (Aph. 9). principles. 

The body continues in the same state of health as long as it returns 
to its wonted weight, without any increase of the sensible evacuations ; 
but if it comes to its standard by larger discharges, either by stool or 
urine, than ordinary, it then begins to decline from its former health. 
(Aph. 10; cf. Parey, Yl, 82, 93, 94 ; cf. Hippoc, 44, 46.) 



104. From too great fullness arise bad qualities, but none vice versa 
(Aph. 18). Too great a weight and fullness may be lessened by sensible reqir^e? 
or insensible evacuations, either of digested or undigested matter, and 
it is good so to do (Aph. 19). 



Plethora 

requires 

evacucition. 



Sweat (or 



105. That perspiration which is beneficial, and most clears the body 
of superfluous matter, is not what goes off with sweat, but that insensi- 
ble steam or vapor (Aph. 21). . . . which becomes sensible when there viable" per- 
is too great a supply, or upon faintings, or upon violent motions (Aph. Unhealthy. 
22). Insensible perspiration accompanied with sweat is bad, because 

sweat diminishes the strength of the fibers. (Aph. 23 ; cf., Hipp. 29, 43.) 

When persons faint from severe purging, I have always observed that when they 
came to, the countenance appeared relieved from great anxiety ; perhaps a congestion was 
broken up, or some troublesome humor removed. 

106. The body is not presently thrown into a disease by an external 
injury, unless some of the viscera be first disposed to receive its impres- Predispo- 



26 THE DOCTRINE OF PURGATION. 

sition for, sioiis, wliicli predispositioii may be known by a greater or less weight 

SL orad- than is customary, and that not without some considerable uneasiness 

rancing di.^ (Apli. 39). The tirst imprcssious of a disease are much more easily 

movecritdi- discernible from the changes of an unusual perspiration', than from the 

^Z^7lfa!'e disorders of any of the other functions (Aph. 42). If, upon weighing, 

J^^j i>"'w- the perspirable matter appears to have been obstructed, and there is 

neither increase of sweat nor urine for some days after, there is a great 

deal of danger of a putrefaction of the detained crudities (Aph. 43). If 

the obstructed matter can neither be removed by nature nor a feverish 

heat, there is immediate danger of a malignant fever. (Aph. 46 ; cf. 

Hipp. 17; cf. Hipp., 37.) 

107. The excrements of the guts which are well digested, are large 
Evacua- ^^ bulk, but light in weight ; they swim because of the included air, 

«Mw^, when and what is ejected at once seldom exceeds the third of a pound (Aph. 

72). 

108. Importance of Ventilation to Invpercejpti'ble P<9r65'.— Nothing 
more tends to prevent a corruption of the hnmors than plentiful ventila- 

tion^^of^fhe tion; not only by that which is drawn in by the lungs, but what is 
lSfs(acUve drawu in through the imperceptible pores. (Aph. 120; cf. Hipp., 10, 

and nega- 55 and 13, 26.) 
tive). ' ^ 

109. The plague is communicated not by any immediate contact, but 
Pestiim- either by drawing in infections air or the steams of tainted furniture ; 

S *Yow ^^^ ^^ ^^ ^^^^ • ^^^^ vital spirits are infected by the air, and from the 

propagated, infectcd spirits the hlood is coagiilated^ which produces hlach spots, car- 

and^^cured huncles and huboes^ and if not sufficiently discharged^ occasion death; but 

^y^py^rga- ^^ .^i^g ^11 thrown out, they escape. (Aph. 127; cf. Parey, 94). 

The above shows the absolute necessity of Brandreth's Pills in Plague, because they 
purge safely. 

Air-\ii H^- The external air which passes through the arteries into the 

^influence^^ body may render the body heavier or lighter ; lighter if it be subtle 

body. and warm, and heavier when thick and moist (Aph. 3, sect. II). In a 

foggy air perspiration is lessened, the pores are obstructed, and the fibers 

weakened and not rendered more firm ; and the weight of the retained 

matter is both perceivable and injurious. (Aph. 8 ; cf 103, 106, 109.) 

^u^mer- Vll. Temperate persons weigh in summer time about three pounds less 

complaint: than in the winter (Aph. 23). That lassitude or weariness which is per- 

how It en- . , , . ^ .^ . J -. 1 1 T • 1 1 • 1 

Bues. itscure cciva Die lu summcr time is not because the body is then heavier, but 

^^i^r^to because it is then rendered weaker (Aph. 24). In summer time the 

^^ItructJi'' ^C)dy is not uneasy from the heat of the air immediately, for every part 

tnaUer. of the body is even then hotter than the external air, but because at 

such times there is not a sufficient coldness to concentrate the natural 

heat. By which means it becomes so scattered that it cannot drive out 

the persjcrirable matter., in its own nature hot, by insensible steams ; which 

matter, by being retained, acquires a sharpness, and is really the cause 

of that uneasiness we are under from a sense of the summer heat (Aph. 

27, sect. 1) 



THE DOCTRINE OF PURGATION. 27 

112. When to Purge. — The autumn is unhealthfiil, both because per- Autumnal 
spiration lessens upon the supervening cold, and because that which is ob- cautestTw^e 
structed acquires an acrimony and a corrosive quality (Aph. 42). They \if^t,j'^a^X 
who are accustomed to a distemper in winter, that arises yV6»m a fullness mbnious ao- 
qf humors, ought to purge in autumn (Aph. 48). tSa!^^^' 

Note, — Our experience is, purge only when the body calls for it — when we have 
pain or oppression, or the bowels are costive. 

113. But for such diseases as arise from noxious qualities, ^urgvug spring the 
ought rather to be used in the spring than autumn, because in the hot pit^^^n^Jbr 
weather such qualities grow worse more than in the wintef (Aph. 49 ; 
of. Parey, 86). 



coni^tituW ri- 
al diseases. 



114. If the obstructed perspirable matter acquires an acrimony, it pro- . Acrimony 
duces fevers and inflaminations / but when it offends only in quantity, and'^'"^^^ ^ 



super- 
abundance 



it causes apostumations, distillations, and cachexies (Aph. 51). caSd 

by purga- 
tion. 

115. When a full meal is not perfectly digested, it is to be known by an insensiue 
increase of weight, for the body will not then perspire well ; but an l^fretion- 
empty stomach is filled with vapors (Aph. 12, sect. 3 ; cf. Apo. 5, sect. 1.) JJ^!? J^^, ^^^de'- 
Robust persons discharge their food for the most part by perspiration ; pending on 
those not so strong by urine ; and the weak chiefly by an indigested ai stren^gtT" 
chyle (Aph. 14). A full or an empty stomach lessens perspiration ; for 

a full one diverts it by corruption of the aliment, and an empty one 
draws it back, that it may be filled (Aph. 11), and the obstructed mat- 
ter will acquire a sharpness, whence the body will be subject to distem- 
pered heat (Aph. 15). 

116. When a person seems to himself lighter than he really is, it is a sensation 
very good sign, because it arises from a perfect digestion of all the juices ofi»eaith. 
(Aph. 19). 

117. That sort of food best perspires, and aifords the most suitable what is 
nourishment, whose weight is not perceived in the belly (Aph. 28). foo^^^^^^ 

118. N^othing more frequently interrupts sleep than a putrefaction of watchful- 
the food, such is the sympathy between the stomach and the brain (Aph. mo?bid mS 
40, sect. 4). From eating comes sleep ; from sleep digestion, and from *^]^^^S?/ 
digestion a good perspiration (Aph. 59 ; cf. Parey, 99). o^ brain and 

119. By exercise bodies are rendered lighter ; for all the parts, espe- Digestion 
cially ligaments and muscles, are cleared of their excrements by motion ; ll'SZ^ t1£ 
the perspirable matter is fitted for exhalation, and the spirits rendered '^°*^^- 
firmer (Aph. 9, sect. 5). Exercise promotes both the sensible and in- 
sensible evacuations ; but rest only the insensible (Aph. 10). 

120'. The heavy part of the perspirable matter beina; more than usuallv " ^f^^^^' 

. • 1 • ;i 1 1 'i '11 T j_ ^ T ■. '^ ness'' from 

retained m the body, it will dispose a person to tear and sorrow ; but obstrncted 
the lighter part being obstructed, to anger or joy (Aph. 5, sect. Y). Therefo^ 



28 THE DOCTRINE OF PURGATION. 

Haevey, William, De. — The works of, written 1628-51/ transl. hj 
BoU. Willis, M. D., andpuUished ly the Sydenham Society. London, 
1846-47. 

tb?w3^" 121. The blood acts with forces superior to the forces of the elements. 
As the instrument of the Great Workman, no one can ever sufficiently 
extol its admirable, its divine faculties. . . It penetrates everywhere, and 
is ubiquitous ; abstracted, the soul or the life, too, is gone, so that the 
blood does not seem to differ in any respect from the soul, or the life 
(anima) itself. At all events it is to be regarded as the substance whose 
act is the soul or the life. . . In one way the hlood is part of the hody, 
hut in another way is the beginning and cause of all that is contained in 
the animal hody. . . That which is abundantly nourished by it, in- 
creases ; what is not sufficiently supplied, shrinks ; what is perfectly 
nourished, preserves health ; what is not perfectly nourished, falls into 
diseases (pp. 510, 11). 

vitiaud, 122. Yitiated states and plethora of the blood are causes of a whole 

iiood. ];^Qgt of diseases (p. 391 ; cf. Hippocr. Works, p. 262, Vol. I., Aphor. 22, 

sect. 2 ; cf. Parey, 68-99). 

i^a^ethe 123. The physiological consideration of the things which are accord- 

mediSLe ""^ ^^^ ^^ uaturc is to be first undertaken by medical men, since that which 

'^^^' is in conformity with nature is right, and serves as a rule both to itself 

and to that which is amiss (p. 90 ; Hippocr. Works, p. 102, Yol. I., p. 

360, Yol. I). 



The timid 124. N"ot yielding implicitly to the truth, he fears to speak out 
thrnewdoc^ plainly, "lest he offend the ancient physic" (p. 91). 



^ 125. Who will not see that the precepts he has received from his 

^ie/ofHa?- teachers are false; or who thinks it unseemly to give up accredited 

vey'stime. ^p^^Q^Q^g . ^^ ^\^q regards it as in some sort criminal to call in question 

doctrines that have descended through a long sifccession of ages, and 

carry the authority of the ancients ; to all these I reply : that the facts 

cognizable ly the senses wait upon no opinions, and that the works of 

th^'^^'Sdest ^^'^^^^ ^^^ '^^ ^<^ antiquity ^ ; for, indeed, there is nothing either more 

authority.^^ anclent or of higher authority than nature (p. 123 ; cf. Hippocr. 47). 



• 



The Uood 



,._ __^ 126. The Uood is the generative part, the fountain of life, the first to 
^'^^' live, the last to die^ and the primary seat of the soul (p. 3Yf). 

The blood is both the author and preserver of the hody / it is the 
principal element, moreover, and that in which the vital principle (ani- 
ma) has its dwelling place. . . The blood, moreover, is that alone which 
lives and is possessed of heat while life continues (p. 379 ; cf pp. 
510, 11). 



THE DOCTRINE OF PURGATION. 29 

Collins, Samuel, M. D., System of Anatomy. London^ 1685. 

127. Cathartics do not only affect the hlood at a distance, but also the aSJ^nSV- 
villous coat and nervous filaments, which do immediately disturb them cines act on 
with troublesome stroaks preceding from the pungent particles of pur- lnd^*°Ste?- 
gatives, vellicating the inward coat of the stomach as a tender compage Jitfon^o/the 
beset with nervous fibrils, which, irritated by sharp medicines, spew out intestinal 

--•' '- _«/. _i - -7r__ nerves, stim- 



the 



serous liquor out of the excretore ducts, derived from the glands of the mating 

mteStmeS. motion and 

The purgation extract of medicines first produced by the ferments the^'^mucous 
of the stomach, and afterwards imparted to the intestines, does highly matter. 
excite the nervous and carnous fibers, and gives a most troublesome 
sensation to the inward coat of the guts finely dressed with fibrils ; and 
afterwards afiects the excretory vessels of the pancreas and hepatic ducts 
with a kind of convulsive motion, making them disgorge their pancreatic 
and bilious recrements, into the larger receptacle of the intestines. 

And not only the feces of the hlood, secreted from it in the glands of 
the liver and pancreas, are thrown into the guts by the excitement of the 
nervous and carnous fibers, but also the extremities of the arteries and 
excretory vessels belonging to the glands, are opened by the sharp and 
aperient qualities of the purgatives, unloching the secret pores of the 
inward coat of the intestines lined with a mucous meatier, which is 
scraped off hy the cleansing qualities of purgatives^ leaving the intestines 
exposed to the active power of raking medicines, which force open the 
extremities of the arteries (p. 369, vol. I). 



1 28. The concoctive faculty of the intestines is disaffected ; first, as it pathology 
is wholly abolished, when no chyle, or very little, is extracted in the tmes.^ 
stomach or intestines. This evil proceeds from the want of natural heat 
deficient primarily in the blood, and from a defect of good succus pan- from^^^^^ot 
creaticus, and bilious liquor, and a laudable serous and nervous juice, stmcUon of 
not being imparted by the extremities of the arteries and nerves to the laidpZrl 
crude aliment lodged in the guts. This disorder is commonly called cnvehjpvr- 
lienteria, an unnatural excretion of the aliment, little or no ways altered, 6'«*^'^^^- 
wherein its compage is not well opened by due ferments, and a secretion 

made of the alimentary liquor from the grosser feces (p. 370). This 
obstruction of the hepatic and pancreatic ducts is cured by aperient medi- 
cines (p. 371). 

129. Another disorder of the intestines near akin to the former, as caeiiat 
differing from it in degree, is the lessened concoction, commonly styled '^{fnferfeJt 
caeliac affection, wherein the food is in some sort digested, and remains digestion 
confused, as not secreted from the gross parts, because the chyle is not «^T compt 
well attenuated by the pancreatic and bilious liquor, and serous and fScuifur^'J 
nervous juice, which are destitute of volatile salt, oily and spirituous ■^'^^^^: ^r^'al 
particles, so as to render the chyle fluid in the intestines ; whereupon the *»« medi- 
clammy chyle embodying with the crude aliment, is excreted by the ex- ^^"'^' 
pulsion faculty (p. 370). This distemper is cured by the same means as 

a lienteria (p. 371). 

130. The third indisposition of the concoctive faculty of the intestines imper/ect 

digestion 



30 THE DOCTRINE OE PURGATION. 

from acrid 1* it^ depravcd action^ produced by ill ferments of sharp hilioios^ and acrid 
Pm-'gr^' _pi^^iicreafic llquoi^ vitiating the extracted aliment in the guts, and after- 
wards spoiling the mass of hlood^ when it is received into association with 
it in the blood-vessels (p. 370). It denotes gentle aperient medicines (p. 
371 ; cf. Parej, 94). 

indige^- 131. Another disaffection of the intestines, and that none of the least 

disorders'^^Sf bccause it concerns the nutrition of the whole body, is when the 
^utivi^fdcui- distrihutive faoulty of the chyle is either wholly taken away or much 
% 1^^ ^^^ lessened, which may proceed either from the clamminess of the chyle, 
lisJlitj/ If or from the grossness of pituitous humors, more or less obstructing the 
humors. orifices of the lacteal vessels seated in the intestines. The cure of this 

disease may be assisted with a light diet and medicines promoting the 

digestion (p. 371). 

sioicness 132. The intestines are also incident to divers diseases in reference to 

from'^JfiS their expulsive faculty^ when the peristaltic motion is too slow, or too 
iveness of quick, or aggrieved with the discomposure of pain. 



Purgatives 

stimulate 

them to acfi 



nui nerves. The slowucss of the motiou of the guts proceeds either from the 
torpid indisposition of the nervous coat, not resenting the irritation by 
gross excrements, when the nervous fibrils inserted into the inward coat 
of the intestines have their acute sense lessened, proceeding from tlie want 
of animal spirits intercepted first in the fibrous parts of the brain, and 
by consequence in the nerves of the guts, produced by cephalic diseases, 
compressing or obstructing the fibrils seated in the brain. This dis- 
affection is cured by proper methods and medicines relating to the dis- 
eases of the head (p. 371). In all the diseases of the hrain, Collins 
recommends purgatives to a greater or less extent (pp. 1133, 1134, 
1138, 1145, 1153, 1163, 1169, 1181, 1194, 1199 ; voL II; cf. Sanctorius, 
118). 



Torpor of 133. The slowness of the peristaltic motion, incident to the guts, may 

unes *from ^^ ^^^o dcrivcd from narcotic medicines, dulling the acute sense of the 

narcotics norvos which terminate into the inward tunicle of the intestines, where- 

movX' by upou they are not sensible of their burden, when they are oppressed with 

gaS.^^^' excrements. This disease may admit a cure by strong purgatives and 

sharp clysters (p. 372). 

Hardened 134. The rcmissuess of the expulsive power of the guts may also 
mofer^ by arisc from the viscid and indurated contents, produced by ill concoction ; 
jjurgat^es. ^^ other from the heat of the guts, exhausting the liquid parts of the 

excrements ; the guts being overcharged with excrements, purgatives may 

be advised (p. 372 ; cf. Hippocr. 13, 25, 26). 

Lientery, 135. The over-hasty motion of the guts is made in 2i lientery 2^^^ 

mseanddi- casUac disease, proceeding from the quantity of crude and indigested 

exIitedpeT- aliment provoking the nervous and carnous fibrils to excretion. This 

^taitic mo^- clisaffectiou of the guts is visible also in diarrhea proceeding from salt 

bT' pur'ga- phlegm and from bilious and serous excrements discomposing the tender 

^'^^*' compage of the guts, and irritating them to expulsion. The cure of 



TPIE DOCTRINE OF PURGATION, 31 

tins disease is performed by lenient and astringent purgatives (p. 372 ; 
cf. Sanctorius, 103; Hippocr. 44, 45). 

136. Inflammations of the guts producing dysenteries are most com- Dysmury 
monly seated in the great gut, which, proceeding from a quantity of SwfprT 
blood impelled by the mesenteric arteries into the intestines, some part of ^talnati^n 
which is stagnant in the substance of the bowels, and other parts are of J"^i'^^« 
transmitted sometimes into the small guts, where it seldom makes any -boweu. 
long stay, as, being thrown from there into the colon, wherein the blood 

is long retained ; whereupon the tender frame of the coats is corroded 
by the sharp blood confined in the deep cavities of the colon (p. 3Y2), 
The vitiated expulsive faculty of the guts coming from inflammations, 
and from an ill mass of blood, is cured by clysters made of healing 
medicines and by purgatives (p. 373 ; cf. Sanctorius,103, 106, 109, 110). 

137. The iliac passion proceeds from divers causes, sometimes from the luacpas- 
small guts twisted^ other times entangled and tied in knots ^ and also fjj^^ .^ ^^^ 
when they shoot downwards and upwards into one another. It may be smnii guts 
derived from astringents unduly used, and from a stoppage of the intes- muiauon of 
tines by viscious matter from hardened excrements, and from flatulent gtnerSiy^ac^ 
matter contained in the guts intercepting the passage of the gross ^X^^Sllle- 
feces. . . Now and then the upper shoots into the lower, and sometimes ness of the 
the lower into the upper part of the small intestines, which are much whkh^is re= 
distended in several places, and in other parts contracted for some space ^^rl^atw"^^ 
both above and below ; whereupon the free play of wind being checked, medicines. 
the patient is highly tortured with pain, and, to ease himself, puts his 

body in divers postures by various agitations and flexures of it. A re- 
laxation is made of some part of the guts adjoining the contracted parts, 
which, being moved forward by the pressure of wind toward the relaxed 
intestines, force them into the next expanded parts of the guts, which 
are afterwards closed up by the duplicature of them, entirely intercept- 
ing the passage of excrements. And when in this miserable distemper 
the lower part of the guts is thrust into the cavity of the upper, the 
pressing down of the excrements, made by art in purgative medicines, 
discharges the insinuation of the lower gut into the upper (pp. 376, 76). . 
The iliac passion may arise out of a gross alimentary liquor or phlegm 
concreted in the intestines, wholly shutting up the passage of them ; 
whence ensues a recoiling of the excrements upward, produced by the 
irregular contraction of the fleshy flbers (p. 377). This disease often 
happens upon a long suppression of natural evacuations l)y stool, gener- 
ated by a load of hard excrements, long residing in the guts, productive 
of intolerable pains (p. 378 ; cf Hippocr. 38, 41, 44). 

138. The colic is near akin to the iliac passion in the situation of the (cf. Parey. 
subject and in the cause of the disease, both proceeding from sharp ^^'^ 
humors productive of vexatious pains, and from the great obstruction ^^^^ . ^^_ 
and tension of the guts, caused by a quantity of gross excreTuents, and cumulation 
more thin and flatulent matter (p. 379). This disease takes up its man- fng^^^ood, 
sion, if not solely, yet chiefly, in the colon. Colic pains are generally tfousZ^attir 
felt in the lower apart/ment of the abdomen, accompanied with nausea, and fi&tuien- 
vomiting, suppression of stools, pains in the hack, &c. . . Colic, accom- ^^' 
panied with heat and beating pains, arises from blood impelled out of /^ symp^ 



32 



THE DOCTRINE OF PURGATION. 



the terminations of the capillary mesenteric arteries into the substance 
of the coats of the colon ; piercing and fixed pains come from sharp 
pancreatic licpor blended with viscid phlegm, or bilious hnmors lodged 
Tvithin the coats of the guts, which produce pungent and wandering 
pains (pp. 380, 81)! . This disease denotes purging and alterative medi- 
cines (p. 382). ' 

Active.re- 139. I conccivc the carnous and nervous fibers are much weakened 
?5?S ^tile by the inflation of the coats of the intestines, whereupon the irritation 
^"'■^- of the medicines is not easily felt, and the carnous fibers do not con- 

tract ; upon this account strong purgatives must be given, or rather gen- 
tle, often repeated, assisted with purgative clysters, wdiich excite the 
peristaltic motion of the guts to discharge the indigested aliment or 
gross vitreous phlegm, or indurated excrements (p. 384 ; cf. Hippocr. 
55 ; Coll. 134). 



Abscesses 
and TJlcers 
of the mer 
sentery. 

Pain^ of 
the hack 
and other 
diseases of 
tka mesente- 
ry — their 
causes and 
cure hj pur- 
gation. 



140. Abscesses and ulcers of the mesentery are cured by gentle purga- 
tives and proper drying diet-drinks (p. 393). 

141. Great pains in the back are not the disafifection of the colon 
only, but of the m.esentery, too. . . Mesenteric affections are often de- 
rived from the serous feculencies of the blood, impelled out of the capil- 
lary arteries into the substance of the mesentery, and from flatulent 
matter distending the fibers of the mesentery. A cure may be attempted 
by emollient and discutient clysters and by purgatives, gradually increas- 
ing their strength, and by fomentations (p. 395). 



Diarrhea 142. When paticuts labor under a great diarrhea, I conceive it very 
'^auL.^^^' dangerous to advise powerful astringents until nature has fully discharged 
herself, or art emptied the guts of gross and more thin excrements (p. 
3Y6 ; cf. Parey, 92, and Hippocr. 2). 

^ .^^ 143. The immoderate use of opiates produces apoplexy, the drug 

the cause of stupifvinff and relaxing the nerves, and causinsr the stagnation of the 
apoplexy, ^ood in the cortcx (pp. 1128, 1129). 

Apoplexy, 1^4:.' The slccpy diseases (apoplexy, earns, coma, lethargy), being 
itroS^pur- ^'^^ ^^ *^^^^ causes, are much alike in their cures, too. . Strong purga- 
gation. tivcs may be given, and after a purgative has been celebrated, vomito- 
ries may be administered (pp. 1131, 1132, 1133). 



Vertigo- 145. Yertigkious symptoms arise from irritation of the nervous 
&/SS- fibrils of the stomach, intestines, liver, pancreas, spleen and kidneys, 
tmMnerves. proceeding from sharp recrements, which, offending the fibrils of the 

viscera, taking their origin from the brain, give a lightness to it (p. 

1136) ; and as to the preservatory indication in an ill habit of the bodv, 

purgatives may be applied (p. 1138 ; cf. 132). 

Deiirivm 146. In phreuitis and paraphrenitis, produced by an undue effer- 

eJSiluon vescence of the blood caused by heterogeneous particles, or by the blood 

o£the bow- being poisoned with malignant qualities (p. 1140), which is induced by 

serous recrements vitiating the nervous liquor (p. 1143), clysters are 



THE DOCTRINE OF PURGATION. 33 

very successful to empty the howels of excrements and winds (p. 1145 ; 
cf. tarey, 94 ; Sanctorius, 109). 

14Y. Melancholy being produced by vitiated hlood and corrupt humors ly^-^^^J!^^^ 
in the viscera (pp.' 1150, 1151), is cured by vomitories and purgatives, 'morua 
removing the gross phlegm from the stomach and discharging gross, ^e tiood"' 
acid, and saline recrements from the blood (p. 1153). 



148. Mania borrows its first rise from an ill mass of blood, caused Marvia. 
by the distemper of the hepatic glands not secreting the bilious from ^loM^ *Jy 
the more laudable parts of the blood (p. 1159). Btrang purgatives are ^'^Sf/^'^' 
used with advantage in this stubborn malady, as they purify the blood 

and nervous liquor (p. 1163). 

149. Frequent and large doses of opiates incrassate the mass of the j.?^^c? mo- 
blood (p. 1167) and nervous liquor, rendering them effete and vapid, so pishness & 
that the brain cannot accomplish the acts of sense and reason, making «^^^*'^*^- 
men mopes and sots. To refine the hlood^ purging medicines, prepared 

with cephalics, may be very proper in those diseases (p. 1169). 

150. The indication to take away the cause of epilepsy is principally fro^t^^tti. 
founded in rectifying an ill mass of hlood and nervous liquor, which ^f^ f^^^ ^^ 
depends much upon a laudable state of the viscera, so that the ill diathe- 
sis of the blood and viscera is taken away by vomiting, purging, and 
bleeding (p. 1181). 

151. Palsy. — The motive faculty is impeded or abolished, because PaUyirom. 
the origins of the nerves are obstructed by the grossness of the nervous ^eS^n*The" 
liquor, which may arise from a thick, feculent, albuminous part in the ^^^^^^ ^^^ 
blood (p. 1193). A palsy sometimes succeeds severe pains of the stomach imperfect 
and intestines (p. 1194), which are produced by an accumulation of bilious The^rSsfep 
and excrementitious matter and hardened feces and dilatation by flatu- ^p^lauon.' 
lency, compressing the beginning of the vertebral nerves and intercept- 
ing the current of the circulating fluid (p. 1195). The antecedent cause 

of palsy is an ill mass of hlood generated by a bad diet, hard of digestion 
(p. 1196). Yomitories may be advised in a foul stomach, but purgatives 
and alteratives for a habitual palsy (p. 1199). In a palsy derived from an 
evident cause — a fall, stroke, or wound — the apertion of a vein may be 
proper, after an emollient and discutient clyster has been administered 
and rejected (p. 1198 ; cf. 139 ; Parey, 83 ; cf 136, 137, 138). 

Sydenham, Thomas, M. D. The whole Works of that excellent practical Sydenham. 
Physician, written about 1686. Transl. Dr. Pechey. London, 1701. 

152. Though a purge does for the present raise a greater tumult in Purgatives 
the blood and other humors, on the day it is taken, and in the operation, ^o'SlestTiTd 
than was before, yet this injury will be sufficiently made up by the ad- ^^^*- 
vantage that presently follows ; for it is found by experience that purg- 
ing quells a fever sooner and better than any other remedy whatever, 

both as it expels those filthy humors from the body, by which, as the 
antecedent cause, the fever was occasioned / and if they were not peccant 
before, yet, at length being heated, concocted and thickened by the fever, 



34 THE DOCTRINE OF PURGATION. 

Filth!/ hu- ^\^^ miicli to render it more lasting (p. 432 ; cf. Hipp. "Works, L, 174; 
Tcedenr W. Harvej, 391; Sanctoriiis, 103, 106, 109, 110; Collins, 136-138, 
151). 



cause. 



Sweating 153. Purging preferable to ^Sweating. — . . . On the contrary, as 

ing '^'?om- that method which is busied in eliminating the febrile matters through 

ihl^h na- ^lie pores of the skin is less certain, so it is more troublesome and 

fe"elf"'^h ^^^^ic>iis ; for by it the disease is very often protracted many weeks, and 

siceating,^ the life of the patient thereby endangered. . . . For this reason I insist, 

SiVehyput- upon good grounds, that purging is more powerful than any other 

gativts. method for the subduing fevers of most kinds, for though sw^eating is 

nature's own method by which she casts out febrile matters, and is more 

sons given geuuiue and commodious than the rest, when nature is left to itself 

most excel- ^^ j^^^^ digosts the aforcsaid matter, and then, when it is well concocted, 

gently expels it through the- habit of the body. 

Yet art, how much soever it may seem to imitate nature, cannot 
arrogate to itself the privilege that it is able to cure fever certainly by 
sweating. For, first, art knows not by what means the peccant matter 
should be fitly prepared to undergo expulsion ; and if it should know 
this, yet it has no certain signs by which it should be admonished of the 
due preparation of it ; so that also it is unavoidably ignorant of the fit 
time for provoking sweat, which it is very dangerous to provoke rashly; 
while if the physician should, by purging, miss his aim in curing the 
patient, yet he will not hurt him (pp. 432-34 ; cf. Gid. Harvey, p. 
286 ; cf. Hipp. 29, 43 ; Sanctorius, 105 ; Parey, 69 ; Hipp. 9.) 

1^^ The above a highly important article. 

f^<^^"^ 154. If the humors are retained longer in the body than they ought, 
Diseases^va- either bccause nature cannot concoct them and afterwards expel them, 
portio^^To or because they have contracted a morbific disposition, they become 
'^SaSr^^'l^ exalted into a substantial form or species, which discovers itself by this 
morbid mat- or that disordcr, that is a2:reeable with its own essence. 

ters. ' ^ 

uke pro- The symptoms of disease^ though to the less wary they may seem to 
arise from the nature of the part which the humor possesses^ are really 
disorders arising from this or that specific exaltation or specification of 
some juice in the hody. For nature is as methodical in producing and 
ripening these as of plants and animals, unless the order of it be dis- 
turbed by some extrinsic thing (as purgation). The species of diseases 
depend on those humors from whence they were generated. (Preface.) 

In Chronic 165. Chronic Discascs. — Nature has not an effectual method in these 
SsS^T' diseases, to eject the morbific matter, as in acute, whereby, we assisting 
and aiming at the right mark, the disease may be cured. (Preface.) 

Note, — ^Purgation usually changes tlie chronic into an acute disease by assisting nature 
to expel impurities ; thus the blood becomes endowed with greater vitality. 

Disease^ 156. A discasc is nothing but nature's endeavor to thrust forth, with 
** ej^t at^ all her might, the morbific matter for the health of the patient, though 
'^^ the cause of it be contrary to nature (p. 1 ; cf. Hipp. Aph. 2. sect. I ; 

Sanctorius, 106.) 



THE DOCTRINE OF PURGATION. 35 

157. Irrtjpurities mixed with the blood affect the whole with a mor- why na- 
bific contagion, partly from the yarious ferments or putrefaction of TJ^eiimpu- 
humors which are detained in the body beyond their due time, because ^*^^«- 

it was not able to digest or evacuate them^ either upon the account of 
their hulk heing too great, or the incongruity of their quality (pp. 1, 2). 

158. What is the Gout but ^Nature's contrivance to purify the blood ^^^*- 
of old men (p. 2) ? 



159. Purification. — Nature performs this office, sometimes quicker, F&cers— 
sometimes slower, for when she requires the help of 2. fever, whereby she ce^sTof^cSJe' 
may be able to separate the vitiated particles from the blood, and after- ^J^°^ ^^'^^ 
wards expel them, the whole business is done in the mass of the blood, any cause 
and that by violent motion of the parts. . . . When this kind of matter i^esJlmpZ- 
is fixed to any part which is unable to exclude it, either upon the ac- 2l?&c ^nd 
count of its conformation, as it is in the morbific matter of a palsy that r,?^^^%, 
the nerves are stufied with, or upon the account of a continued flux of low. hemrl 
new matter, wherewith the blood is vitiated, which is only disposed to cessaryf^^ 
carry it ofi*, does oppress and overwhelm the part. 1 say in these cases 

the matter is very slowly or not at all concocted, and so diseases that 
proceed from such unconcocted matters are, and are called, chronic 
(pp. 2, 3 ; Cf. p. 432 ; 19. ; W. Harv. 90, 391 ; Sanctorius, 112). 

160. He will not be mistaken much who should affirm that more Diseases 
diseases arise hence, viz., from the omission of purqinq after autumnal •^^/"* ^*^* 
diseases, than from any other cause whatever (p. 21 ; Cf. Hipp. Aph, uon. 

12, II. ; 43, 56, YI. ; Works, TOT, II. ; T28, II. ; Aph. 32, lY). 

161. All means to avoid disease or infection are useless, if the hody is 
furnished with humors disposed to receive the infection (p. 59 ; cf diseaslfthe 

HippOC. W. 102, I). Se^pure."""'* 

162. Cholera. — Should I restrain the first effort with narcotic medi- cuura- 
cines and other astringents, whilst I hindered natural evacuation, and de- ^|/[*^^^^^* 
tained the humors against nature, the sick would undoubtedly be 
destroyed by the intestine war, his enemy being kept in his bowels (p. 

115 ; cf. Hipp. Aph. 2, I. ; 21, I ; Collins, 142). 



163; ^denham on Hippocrates, Nature and Disease. — The excellent mppo rates' 
Hippocrates who arrived at the top of physic, laid this solid foundation ^^r^' cure's 
for building the art of physic upon, viz., i^ature cures disease, and he f^'^'^gi^^ 
delivered plainly the phenomena of every disease, without pressing any piyadescnp- 
hypothesis into his service. He also delivered some rules gathered from lure. ° Art of 
the observation of that method that nature uses in promoting and '^^t^'i^^'J^ 
removing diseases, and of these things consisted the theory of the divtne ^'^''« opiy ^y 
old man . . . This theory was nothing else but an exquisite description S^simpie. 
of nature ', it was reasonable that in practice his only aim should be to 
relieve her, when she was oppressed, by the best means he could ; and 
therefore he allowed no other province for art than the succouring of 
nature when she was weak, the restraining her when she was outjrageous. 



36 THE DOCTRINE OF PURGATION. 

and the reducing her to order^ and to do all this in that way and manner, 
wherehy nature endea^vours to expel diseases ; for the sagacious man per- 
ceived that nature judges diseases, and does in all, being helped by a few 
simple forms of remedies, and sometimes without any (preface ; cf pp. 
432, 2-3 ; W. Harvey 123). 

\%^. Bcarlei Fever. — I reckon this disease is nothing else than a 
Fever. ^^ moderate effervescence of the blood, occasioned by the heat of the fore- 
going summer, or some other way, and therefore I do nothing to hinder 
the depuration of the blood and the ejecting of the peccant matter 
through the pores of the skin, which is easily done by the blood itself. 



PurgaUves 



166. But when the scales are gone off and the symptoms ceased, I think 
ci^e."" other it propcr to PURGE the sick with some gentle medicine that is agreeable to 
stroy/^^ ^ his age and strength ; and by this simple and plain natural method, this 
name of a disease, for it is scarce anything more, may be easily and 
safely removed. Whereas, on the contrary, if we disturb nature by 
cordials and other needless remedies too learnedly thrust in secunduim 
artem^ the disease is hightened and the sick dies by the over-officiousness 
of the physician (pp. 189-90). 

166. I think pleurisy is a fever originating in a proper and peculiar 
a mtuTaf ?t- inflammation of the blood, an inflammation by the means of which 
tempt to cure natuTc doposits the peccant matter in the pleurae. Sometimes she lays 

by ehmtn at- . i i • i /> i t i • • rm • t rv> 

ing morbid it ou the luug itseli, and then there comes a peripneumonia, ihis diners 
metiood.^^ from the pleurisy only in degree. It exhibits the results of the same 
cause with greater intensity. (Society's Ed., vol. I., p. 247.) 

Harvey Gideon, M. D. The Vanities of Philosophy and Physick. 
Zd edit. London^ 1702. 

167. 1st. Things in philosophy and medicine which we do not know, 
Uncertain- ^^® bcyoud all mauucr of comparison more than those things we do 

ty in medi- kuOW. 

2d. The greatest part of these things in medicine, which we pretend 
to know, is conjectural and uncertain. 

3d, Many if not most of these things which we do peremptorily 
affirm to be this or that, to be caused by this or that, or to cause and 
effect this or that, are or may be proved to be false (pp. 7, 8 ; cf. 
Parey, m ; cf. W. Harvey, 124-126). 

Tfi.& Hood 168. The antecedent causes of most diseases are the fluid parts of the 
dSeSse^ ^^ blood, the fluid animal lynvpha^ the glandulous lympha, and the- hlood 
being vitiated (p. 139 ; cf. F. Harvey, p. 391). 

Theory of 1^9. How True.— Thc wcakucss of the stomach and its faintly per- 
forming its office, is only occasioned by the debility of the stomach- 
nerves, and their various branches, by being plastered up by too much 
fleam^ gross and acid dregs^ indigestible rneals^ or offensive drinJcs^ or 
other matter admitted into the stomach, which, by lodging there too 
long, assume a corroding quality. . . . (cf. Sydenh., Prof.). 



THE DOCTRINE OF PURGATION. 



37 



170. This supposed, I do believe, and have experimentally observed, 
that all those corroborations of the stomach, whose virtue is commonly eifrl^^^o 
asserted to consist in a gentle restrictive and warming quality — whereby notstrength- 
these slimy humors are more iirmly cemented — so far from contributing 
the least strength to the stomach, being long continued, do carry danger 
with them (p. 227). 



171. The only means I have hitherto found to strengthen the stom- 
ach are proper abstersive medicines, gently wiping off those clammy sub- 
stances from the tunic of the stomach, and the terminations of the nervous 
branches. . . . Do only heep your stomach clean^ you will certainly pre- 
serve its strength, and jprevent most diseases (p. 228 ; cf. Hipp. Aph. 8, 
sect. II. ; Parey, 87). 



Purgatives 

the only 

strength- 

eners. 



172. Herodotus (in Euterpe) who was contemporary with Hippoc- 
rates, tells us that the Egyptians, to whom the first invention of physic 
is ascribed, used to take purging-physic, for three days together every ^f'^tTli 
month, for no other purpose than to cleanse their stomachs, knowing they among the 
could be subject to no diseases but what the foulness of their stomachs E^^^tians. 
might occasion, in regard their bodies were strong, and their air the most 
clear and temperate in the world, (p. 232). 



173. It is not to be understood, where a heap and weight of crudities 
is accumulated, that gently absterging remedies can have power to disen- 
gage the stomach, any more than a wet mop can be supposed to rid a room 
of a heap of rubbish, — in which case something more stimulating is re- 
quired, that may be used in all seasons of the year, be it sultry or freezing, 
without the inconvenience of confinement to diet or warmth of air, or 
without ofience to the stomach, or putting the body into any disorder ; 
to which purposes the pill I here now describe, I have experimentally 
found to be effectively answering in most respects, (p. 228). 



I'uU pur- 
gation. 



Brandreth's Pills are superior to the following in all tlie elements of cleansing physic. 

. 174. Take one ounce of the clearest shining aloes ; powder it in a 
mortar, covered over with a brown paper having a hole in the middle 
for a passage to the pestle. Observe to anoint thinly the bottom of the 
mortar and pestle with a little Florence oil, to keep it from sticking to 
the bottom. When it is reduced to a gross powder, by grinding it with 
the pestle you must bring it to a smooth fineness. Put the powder into, 
a small glazed flat-bottomed earthen pan, that will contain about half a 
pint, pouring upon it about a quarter of a pint of water, wherein has been 
dissolved 2 drams of Spanish juice of Liquorish, which is done by slicing 
it very small and setting the water in a porringer over a gentle heat ; 
place this same earthen pan into one somewhat bigger, having sand in the 
bottom to the height of an inch, and afterwards filling _ it up to the 
brim. Set them over two piles of bricks of three or four bricks laid fiat. 
The piles must stand at such a distance, that they may reach the edges 
of the bigger pan to support it. Then make a moderate fire of charcoal un- 
der it, to heat the same, to cause the superfluous moisture to be evaporated, 



The ffar- 
eyPill. 



38 THE DOCTRINE OF PURGATION. 

until tlie aloes is brought to tlie thickness of honey. Or you may, by drop- 
ping two or three drops on the back-side of a plate, to cool, make a trial 
whether it be reduced to the consistence of dough ; for if it be over- 
done, the mass being rendered brittle, will not only lose most of its 
virtue, but also its aptness of being framed into pills ; and if it be not 
evaporated enough, it will be sticky, and not apt to be brought into a 
mass. The lesser pan being taken off, when the evaporation is sufficient, 
before it is quite cold, you must with a spatula or slice take out the mass, 
and between your fingers, being a little anointed with Florence oil to pre- 
vent the sticking, roll it into a round ball, which you may keep in a 
sheep's-bladder, being likewise thoroughly wetted over on the inside with 
the same oil, for many months, if necessary. A small piece of this mass 
being formed into 6, 7, 8, or 9 little pills of the bigness of a pepper-corn, 
is a dose sufficient to give two or three motions. 

The safeness of this medicine adds much to its character, since the 
taking of one pill, or two, more or less, imparts *as little hazard, as the 
taking it very often, or in any kind of season, be it hot or cold, &c. . . . 
By the addition of the use of Liquorish, the aloe is designed to be obtused 
in its too purgative qualities, whereby it is apt to raise the piles, and 
become somewhat less precipitating, &c. 

The same correction may be obtained by taking a large handful of Bug- 
loss or Borrage-leaves, and stirring half a pint of warm water with them 
in the bruising, and clarified by subsidence in letting it stand in a cellar 
for a day or two, and pouring it off the feces or dregs in the bottom. 
This evaporated in the same manner, will produce a mass almost equal 
in goodness to the former, (pp. 223 — -5). 

The whole of what follows in Paragraph 175 is equally applicable to Brandreth's Pills, 
whose virtues far exceed all other cleansing medicines the world has yet seen. 

175. I cannot but heretofore observe, that the use of these pills, though 
frequently taken, according to the time the stomach, by reason of its 
degree of weakness in the digestive faculty, may require, does in anywise 
Purgatives debilitate those that may properly use them ; but on the contrary, rath- 
do^not weak. ^^. (3Qpj.Qi3Qi.ate their stomach by assisting it, to throw off that heap of rub- 
bish and crude humors, which those that eat and drink plentifully, and 
either live sedentary lives, as many that are educated to professions, or 
others that are not used to exercise or labor, are subject to engender, 
especially if naturally of a weak constitution or of an advanced age. 
(p. 235). (cf. Hipp. Aph. 8. Sect. I). . . For three or four days succeed- 
ing the use of these pills, a good £Jlixer proprietatis taken morning and 
evening, in a proportionate dose, has, by my observation, ever had the 
good effect of preserving health and preventing disease, (p. 235.) 
(cf. Sydenh. 153). 

1T6. As lesser purgatives do rather contribute strength, by their con- 
pv/rgaimM sequcucc, SO the greater^ being properly used, do not carry that danger 
strengthen with them pcoplc commouly imagine, since I have known many that, 
weaken. ' for three months successively, have taken strong churlish purging pills, ev- 
ery morning, some few days only omitted. I may say some have swallowed 
a bottle of strong purgative pills in a few years, and lived in full health 



THE DOCTRINE OF PURGATION. 39 

to a remarkable old age, and not without a libertine mode of eating and 
drinking. Whence it is apparent, that the toughness of the nerves, upon 
which the strength and action of the bowels only depend, does suifer as 
little by the strongest purgatives, as an Indian cane by a thousand times 
bending, which notwithstanding will recover its former figure and full 
strength, (p. 236), (cf p. 223). 



Our experience and the experience of all who have used Brandreth's Pills confirm these 
remarks on bleeding. 



177. It were to be wished that bleeding could be admitted with the same 
safety, of which it may be justly said, that the lancet has, and does in 
proportion kill more men, than the sword ; and it is as commonly observed, 
that those physicians who do so generally practice it, know little else 
what to do. (p. 236.) ... It is a consequence an idiot infers, because 
a person having been bled eight or ten times in a great distemper, does 
recover his health, he owes the benefit of it to the bleedings, whereas it 
ought rather to be said, neither the distemper nor the bleeding could 
kill him. (p. 237). 



ON LAUDA]SrUM. 

178. I stand amazed at the folly of mankind that is so easily allured, 
by vain boasting and mendacious encomiums upon Laudanum Uquidum^ Laudanvm 
plainly prepared or disguised ; to the frequent and constant use whereof '"^^^ ®^^'^- 
a man being once debauched, under the pretence of ease, and quieting 
himself of a few gripes, fumes or vapors, he can no more leave it off for 
a fortnight, a week, or a day, than a laborer his bread and cheese, or a 
man throw off his coat and waistcoat in a hard winter, or a brandy- 
drinker forsake his spirits and return to small-beer. Using onesself to 
such plain or disguised opiates, after some months or a few years, is like 
making a contract with the devil to live easy and well for a few years, 
upon condition he shall have his soul to torment afterwards. For certain 
it is, that the familiar use of opiates, after some months or- very few 
years, does wholly desist from being friendly, by suffering your trouble 
or distemper to return in a more horrible manner, or create a new one 
incomparably worse than the former, or strangles you with an apoplexy. 
Or some other soporous distemper, which is most amply proved by those 
that make opium their sacred refuge in every fit of the gout, colic or 
stone, who seldom or never fail of a speedy exit, by some incurable dis- 
ease of the brain in " very few years. And those that do advise such a 
lethiferous remedy for a common use to their patients, have a greater 
title to a halter labelled with an inscription of " Mathews' Pills," or 
" Pacific Drops," than those that murder a man on the highway, (pp. 
237-38.) ... In short all strong narcotic medicines occasion weakness 
of the stomach-nerves, numbness, palsies, lethargies, loss of memory and 
dullness of understanding, diminish and deprave all the offices, actions 
or operations of the bowels, suppress the appetite, occasion a wildish 
countenence and paleness, and at last, upon long usage, usher in death 
(pp. 238-39.) (cf. Collins, 133). • 



40 



THE DOCTRINE OF PURGATION. 



Purgation 
preserves 

and pre- 
vents. 



179. To preserve health and prevent disease in valetudinary consti- 
tutions — for strong, vigorous bodies stand in no need of other preserva- 
tions or preventives, than moderation in their nonnaturals^ the know- 
ledge and sense whereof nature has implanted in all other animals, as 
well as in man — no better ways and means can be used, than applying 
at certain intervals to those cleansers and abstersers before mentioned, 
(p. 239). 



Hemorr- 
Aoides. 



Harvey'' s 
Liniment. 



180. For those subject to Hemorrhoides, the following Liniment 
Electuary is recommended. Four ounces best Cassia Fistularis, newly 
drawn and evaporated to a consistency — the manner of doing it you may 
read in a treatise called the " Family Physician and House Apothecary " 
— Rhubarb, powdered, while Mechoacan, grated and powdered, and 
clean Rhenish (not cream of) Tartar powdered, of each a quarter of an 
ounce, Sweet Fennelseeds, powdered, a dram and a half, Syrup of Mash- 
Mallows, as much as will suffice to make them into an electuary, (pp. 
239-40). Take half an ounce or an ounce, dissolved in a quarter of a 
pint of thin gruel, barley-water, po§set, or thin chicken-broth, according 
to directions given concerning the aloetics. (p. 240). 



Har'vey\ 
Emetic. 



181. In Headaches from over-eating or drinking^ in Apoplexies^ 
Palsies, Fevers, c&g., when purging medicines are too tedious in their 
transportation through so long a space, as the roundabout of the guts, a 
vomit that will throw up immediately through the gullet, by a short 
passage, the whole burden at once and operate kindly, without disturb- 
ing any of the other bowels, or raise a mud in the humors — antimonial 
vomits are excluded, as being too long before they operate, too churlish in 
disturbing all the bowels, and exciting a violent commotion in the 
humors. Ipecacuanha, that new fangle, brought by the French from the 
West Indies, is the root dried of a mere common j^Wc^^s whereof, in the 
places where it grows, you may buy a cartload for a two-penny looking- 
glass, or a penny-worth of bugles, though at Paris they have the confi- 
dence of selling it at thirty or forty livres a pound, — which, notwith- 
standing, our asarum-root does far exceed in the operation — than which 
there can not be a more unacceptable drug to the taste in the world, 
&c. . . Take the purest White Vitriol, one and a half ounce, being pow- 
dered and ground very fine, put it into a glas^ bottle-bolt-head, pour 
upon one and a half pint of springwater, and half a pint of clean English 
Spirits, once rectified, which they call Double Spirits. Close your boft- 
head with a cork and a wet bladder over it, tied with packthread. 
Place the bolt-head standing upright in a sandbath and let it digest, with 
a moderate warmth, twenty-four hours. But remember to shake the 
bolt-head very well, before you place it in the sand. After this digestion 
decant the liquor gently into a glass funnel, wherein is placed a coffin of 
cap-paper folded according to art, and so let it filtrate into a glass bottle. 
When it is almost quite passed through to the quantity of a spoonful, 
take out the funnel and throw away what is left. If you filtrate it a 
second time over, it will be the clearer and more depurated. This is a 
very easy, 'gentle and safe vomit, operates nimbly, and for cheapness ex- 
ceeds all others. It may be kept always ready upon every occasion, 
without making aity bustle, and so lasting, that its virtue continues for 



THE DOCTRINE OF PURGATION. 41 

many years ; and for the most part it will move a stool or two, whereby 
it carries oii" those crudities that are remaining in the stomach, or that 
are escaped into the guts. When you find occasion for using the vomit, 
you must pour out three, four or five spoonfuls, according to your easi- 
ness or difficulty to vomit; ])ut commonly three spoonfuls is enough. 
This must be mixed with double the proportion of vi^arm small-beer or 
v^arm w^ater, wherein a little Carduus has been boiled, or thin gruel ; 
then drink it off. If this do not operate in a quarter of an hour, take a 
spoonful or two more, or you may load yourself with carduus boiled in 
water until you vomit. This may be taken safely in the beginning of 
most distempers without any further consultation, (pp. 244-45). 

Gideon makes a grave mistake in respect to Ipecacuanha. It is one of the best and most 
safe roots ever applied to the use of man, as a vomit or purgative. It is one of the ingredi- 
ents of Brandreth's Pills. When a vomit is needed take four Pills, and drink hot boneset 
tea, and your stomach will surely discharge its contents. 

182. About throwing off the febrile matters by sweat. ^ 

. . . Whether diaphoretics ought to be used before the declination theKeand 
of a fever, at which time only they appear to be healthful in assisting f^p^S^ 
nature to throw off, for it must be owned by all experienced practition- 
ers that the causa febrilis, be it vicious humors, heterogenous particles, 
or what other offensive they are pleased to allow, must be first sub- 
dued, or digested and separated, before it can be expelled by sweat ; and 
therefore, should you exhibit the largest doses of diaphoretics that nature 
can possibly bear, and second them by loading the patient with a num- 
ber of bedclothes, he will scarcely be brought to sweating ; and if, per- 
adventure, he should happen to be forced into a sweat at the augment or 
state of the fever, it must be a very great detriment. . . Supposing, 
fictitiously, that diaphoretics were proper, the uncertainty of their oper- 
ation would often occasion a failure of the effect that is expected from 
them. Purgatives and vomitories seldom or never fail in their operation, 
if justly dosed, but sudorifics and diuretics very often, though adminis- 
tered in great quantities (p. 286 :■ cf. Sydenh., pp. 432-434). 

The advantage of Brandreth's Pills is that they require no care, and whether taken in 
large or small doses are sure to be of service. In full doses the beneficial effects in all se- 
vere diseases are at once evident. And when the system requires a vomit they usually act 
on the upper passages of the stomach. But the additional use of hot boneset tea, after a 
dose of four or six pills, is sure to act as an emetic and without any danger. Some gruel 
should be ready for the patient to take after the vomiting is over ; this is needed, when sleep 
will follow. 

Haevey, James, M. D. Prcesagium Medicum. London^ 1720. 

183. In delirious distempers great hopes of recovery are had from 

all sorts of evacuations, chiefiy because they check the velocity of the d^u^^^ ^ 
blood, diminishing its quantity, take off its obstruction, and relax the 
nerves (p. 10). 

184. Pains, especially if they be fixed a long time in any of the 



42 THE DOCTRINE OF PURGATION. 

noble viscera, impair tlie strength of the patient, and obstruct the circu- 
impiltier'^ hition of the blood, concoction, and secretion of the humors. . . But in 
acute disease it is accounted a sign of recovery when pains invade the 
legs and feet, and happen upon a crisis or signs of it. 

185. But though such pains speak an impetus of the blood and force 
Th6 Crisis, ^f iiature to throw off the matter of the disease upon those more igno- 
ble parts, yet, when they go off without any apparent cause, as the ad- 
ministration of medicine, or natural evacuations, the huTnors may he 
justly suspected to have returned into the mass of hlood^^ by which the 
case is rendered more dangerous than it was, and a happy event of a 
crisis in acute distempers, depending upon mere chance, or a favorable 
turn of nature, is always uncertain and never to be relied on (p. 30 ; cf. 
Sydenh. 432: M. Harv. 391 ; G. Harv. 139 ; Collins, 130V 

Uq^ na- 1^^- I^ ^^® ordinary and natural motion of fluids that serve either 

ture removes for nutritiou or cxcrction there are necessary passages or channels 
OT ^otherwise through whicli they run easily, but in extraordinary cases, as all diseases 
^s^ses of ^^^^ nature finds out extraordinary ways by which it throws out the 

noxious matter, or at least puts it in a less dangerous place (p. 43 ; cf. 

Hippoc, Edinb. ed. Epidem., lib. ii., sect. 5 ; Parey, 69). 

187. The animal life depends upon many and different causes, and 
Ufe, Health an integrity of all the parts of the body, especially those that are prin- 
^ease. cipal, as the head, heart, arteries, and veins, and the liquors that run in 
them, namely, the blood, chyle, &c. But because our bodies cannot 
always continue in the same state, its parts, both solid and fluid, being 
worn, consumed, and dissipated by continued motion, there must be a 
continual supply of food for its reparation, as well as proper instruments 
and vessels, in which it may be prepared and made fit for that nurpose. 



The Stom- 



188. N'ature, therefore, has contrived the stomach.^ intestines^ and 
glands^ in which, by a wonderful mechanism, our food is pounded and 

aoC ^'^"' concocted, and its grosser parts separated from those that are more fine 
and subtle, the one for the preservation of life, and the other as the 
useless, to be thrown out by emunctories ordained for that end. But 
when those instruments are defective — which often happens — and the 
muscular force of the stomach is insufiicient to grind the food and make 
a chyle of fine parts, that which we receive for nourishment and repara- 
tion of our hodies not heing duly prepared^ is so far from heing useful 
that it is rather hurtful to us. For this unconcocted food or crudity 
entering into the mass of hlood^ renders it viscious, tough, and of a clary 
substance, unfit for motion and circulation, and the cause of most dis- 
eases (cf. Collins, 137 ; Sanctorius, 109, 101*). . . 

189. "Whatever, therefore, is useless to the body, or inconsistent with 
the hlood, must he separated from it, that it may be preserved in a per- 



* At these times an extra dose of Brandreth's Pills should be administered. 



THE DOCTRINE OF PURGATION. 43 

feet state. Hence the endeavors of nature^ and the contrivance of the 
intestines^ cuticular glands^ and other emunctories appropriated indeed une^^ "^and 
to their jpecxdiar excrements^ hut soTuel/imes com,mwi to all or most of them 
(p. 92 ; G. Harvey, 16B). 



their vica- 
rious office. 



190. Evacuations by sweat are to be attempted with the greatest 
caution, not indiscriminately by all persons nor at all times. For if Forced 
medicines to procure it be given when the blood is of a texture not open f^-" a^ger 
enough — which it cannot be near the beginning of most feverish dis- 
turbances—or when too heterogeneous substances abound in it, forced 
sweats oftener dispose the blood to stagnate in the tender vessels of the 
brain and nerves than to separate its noxious particles at the designed 
secretory parts (p. 129 ; c£ Sydenh., pp. 432-434 ; Gid. Harv., p. 286) 



Assist na- 



191. Nature — by which I mean the eifects of matter and motion, 
according to the laws and constitution of animal economy — is indeed ture by pro- 
the great physician and cure of disease; so that now-a-days several dis- ^awmT. ^ 
turbances are happily taken off by the slightest remedies, or by a mere 
abstinence from them. But, in acute diseases^ the die is cast for life or 

death, and in this case nature is not to be altogether relied on ; neither 
must we, as the advocates for the doctrine of crisis, patiently wait for 
the issue of the conflict between nature and the disease, the peccant 
humors of some fevers being sometimes so stubborn, that art must in- 
terjpose to promote their evacuation some other way. (pp. 207-8.) (Cf. p. 
92 Sydenham, 163, 166.) 

WiLLAisr, J., M. D., An Essay on the Kinoes Evil. London. 1735. 

' ' ' ^ ^ ' Diminish 

the morbid 

192. The diminution of the morbific matter, hoth in the primae vim ^q^*^\^^^ 
and tohole hody. i-s to be effected by cleansing; that canal, and evacuatins^ *^« <^(^^se. of 
the morbific matter out of it ; and ' by this means we cannot fail of 
lessening its quantity in every other part of thehody. (p. 21.) (Cf. J. 
Hamilton, 218.) 

• 

Purging with Brandretli's Pills infallibly lessens the quantity of impurities ; and as they 
are harmless to the most tender age, or the weakest or most feeble, they can be used every 
or every other day, reducing the sum of unhealthy matters contained in the body, and thus 
taking an extinguisher or weight from the blood, whose vitality becomes thereby increased, 
and all the parts of the body be duly nourished into £• renewed life and vigor. 

Pringle, Sie John, M. D., on the .Diseases of the Armies. London^ 
1753. U Ed., 1761. 

193. Early Sweats. — It has been usual to give the theriaca, or some ^^^^^ 
other hot medicine for this purpose ; but all such increase the fever, if sweats. 
they fail in bringing out the sweat (p. 131), 

194. The hilious or remitting fever of the camp begins with chilli- 
ness, lassitude, pains of the head and bones, and a disorder at the stom- and'^remit- 
ach. At night the fever runs high, the heat and thirst are great, the sym'pSms!"" 



44 THE DOCTRINE OF PURGATION. 

tongue is parched, the head aches violently, the patient gets no better 
and often becomes delirions, but generally in the morning a perfect 
sweat brings on a remission of all the symptoms ; in the evening the 
paroxysm returns. These periods go on daily, till the fever changes 
insensibly either into a continued, or into an intermitting form. Some- 
times loose stools carri^ of the fit and supply the sweats. Although the 
effort^atjj^re f^yQ^ most frequently appears in the form of a quotidian, yet sometimes 

when evacti- it is to bc sccu in a tcrtiau shape I rememher of no natural evacua- 

poice\fui'^ lions malcing a complete cure^ unless when a violent discharge super- 
'veiied of the corrupted Mle, or other humors which seemed to he the cause 
of the disease (pp. 165-6Y). (Cf. J. Harvey, 190.) 



Nature's 



Sweat 



195. When the sweat is abundant, the putrid parts of the blood are, 
either wholly or in some degree, expelled, after which the fever is either 
entirely cured, abated or brought to intermit, (p. 183,) (cf. 194.) 



Evaeua- 196. On MUous fevcrs in Britain. — Instead of evacuating or correct- 

iioTis pre- \^„ what is amiss, we often neelect it, till it ends in obstructions of the 

vent many ,& m t \ ^ n t • , > i , n 

forms of mscera. So that hence may proceed nervous complaints without lever, 
sease. ^^ fevers of a nervous hind, instead of fluxes, interiniiting or remitting 
fevers, the common consequences of a more sudden and thorough cor- 
ruption of the humors, (p. 200.) (Cf. Collins, 132, 135.) 

Why the 197. Wc may observe that the fibres are more relaxed in the spring 

th??tt?st ^^ "^^^^ ^^ *^® winter ; hence that the body becoming more plethoric, the 

season to humors wiU then be apter to corrupt, upon any suppression of perspira- 

^^^^' tion. And this may perhaps be forwarded by the eflhwia arising from 

all putrid substances which, being locked up during the cold of winter, 

are then set at liberty by the greater heat of the sun. (p. 201.) 

198. Dysentery. — We must at all times attend less to the dose than to 
ifceifeM^X ^^ ^ff^^t^^ which are never to be judged of by i\iQ frequency but by the 

servations laroencss of the stools, and the relief the patient finds from the qripes 

the we of and tenesmus after the operation. The motions are generally more fre- 

purgatwes. q^^gj^^ from the disease alone than from the purgation. As on the one 

hand, the physician must avoid all the rough and stimulating purges, so 

on the other hand, he is not to spare those of a lenient kind. (p. 240.) 

The necessity of continuing the physic is to be determined more by the 

awi^'a^trin- obstiuacy of. the gripes and tenesmus, than by blood in the stools. 

nfitf dan'^^er- ^^^^^<^'^^ such frcquent evacuations, it is in vain to attempt a cure • as all 

ous pallia- opiates and astringents by themselves only palliate and render the disease 

^*'^^*" more fatal in the end. (p. 241.) (Cf. Sydenham, 162 ; Hippocr. 8. G. 

Harvey, 175, 176.) 

199. As to opiates, it were better they were never used at all, than 
■^/?r/* ^ given before the first passages were thoroughly cleansed ; for though they 

afford some ease, yet by penning up the wind and corrupted humors, 
THEY FIX THE CAUSE. This I prcsumc to affirm from repeated experience. 
1 am well assured, that the fluxes I have seen in the army, are never to 
be cured without evacuations, (p. 241-42.) (Cf. J. Harvey, 191.) 



'cauH6 " of 
the disease. 



THE DOCTRINE OF PURGATION. 45 

200. In some cases the patient would seem likely to recover, but 
would relapse upon voiding hard scybala which, coming away in small fecesThe^'*^ 
parcels for several days together, made a constant irritation. These, easerto**be 
therefore, were to be speedily removed by a full dose of rhubarb with J^^^^^^^J®' 
manna, or by some other lenient physic, (pp. 245-46.) (Cf. Collins, lescence en- 
134, 139, 151.) 

201. Palsy. — Of purgatives the most active should be selected, and 
such as influence most energetically the principal secreting Viscera ; as paUy— 
calomel, colocynth, jalap, scammony, &c. In paraplegia^ and even in g^SoSs. ^"''' 
hemiplegia^ the bowels are very torpid, and require repeated and full ^^^^l^^ 
doses of ihose^ and even of still more energetic cathartics, as cro ton-oil, gia. 
or elaterium, in some obstinate cases. In many cases recourse should 
also be had to purgative enemata. It is not merely necessary regularly 
to evacuate fecal matters by means of these, but to employ them so, as to 
derive from the cerebro-spinal axis any increased flow of blood to it, 
which may have occasioned, or prolonged the attack. Indeed,^ with 
these conjoined objects, they are advised by Halle^ Dalherg, Brodie^ and 
others, who have insisted on their use. (p. 242.) (Cf. J. Harvey, 183 ; 
J, Harvey, 171, 175, 179.) 

I have advertised the above sentiments for forty years, at an outlay of more than a mil- J 

lion of dollars, and long before I saw the above able remarks, j 

I now insert the following testimony, which applies well to Sir John's remarks. 

The following was published in 1863. It tells its own story : 

SANITARY COMMISSION. 

" "What is it doing to economize the Life and Health of our Soldiers ?" 

" Is it using all the means Providence has placed within its reach, or is it stiff-necked, 
and determined that so great a remedy as BRANDRETH'S PILLS shall not be used to econ- 
omize the life and health of our Soldiers ?" 

Sagacious men believe that the administration of BRANDRETH'S PILLS, in its 
" Homes" and as " Special Relief " would more than quadruple the present value to the 
" Life and Health of our Soldiers." 

Let the following testimony from sixty returned volunteers be studied by members of the 
United States Sanitary Commission. If the statements be true, can they be doing their 
duty as Christian Men in not using the means Providence has placed within their reach ? 



FRIENDS OF SOLDIERS— READ . 



JBrandreth's Pills protect from the arrows of disease, usually as fatal to soldiers as the bul- 
lets of the foe. j 

Sing Sing, October 26, 1863. | 

We, the undersigned, surviving members of Company F, Seventeenth JN". Y. Volunteers, 
hereby certify that we have used Brandreth's Pills during our two years' service, and to 
them we attribute the fact that our constitutions are uninjured by the necessary hardships 

and privations of a soldier's life in the field. In costiveness, colds, chills, diarrhoea, dysen- i 

tery, and typhoid fever, their prompt use cured us in a few days. Our health was often ; 

restored without having been entered on the sick list ; in fact, a single dose of four or five • |j 

pills usually cured what, under the regular treatment, would have been a serious sickness. |l 

Others, who appeared to be sick in no way different to us, but who used the remedies pre- I 

scribed by the regimental surgeon, either died or were sick for weeks in the hospital. I 

When we left Sing Sing, in June, 1861, you gave us a supply of these Pills, and we feel 
sure, from our experience, that if every soldier was supplied with this medicine, the gen- ■ 

eral health of the army would be greatly improved. For ourselves, it is our sole remedy, ! 

answering all our wants in the way of physic, and we have known and tested it from our j 

childhood, and our parents before us. ! | 



46 



THE DOCTRINE OF PTTRGATION. 



John Yickars, Captain; J.J, Smith, \st Lieutenant ; "William See, \st Sergeant; G. H. 
Dearing, '■2,d Sergeant ; Dennis Shay, Zd Sergeant ; Patrick Cullen, Ath Sergeant ; Benj. F. 
Brown, \d. Corporal; Wm, Mathers, 2c? Corporal ; Noah W. Miller, 3c? Corporal ; Theodore 
QvoiwX, Drummer ; Geo. B. Coe, Drummer. 

Francis J. Jenning, William W. Campbell, William J. Charlton, Albert Wesley, John W. 
Griffin, William Holmes, William W. Rider, Martin See, George Ackerly, Hiram Seagle, 
Alfred Wilkins, William Griffin, George Ayles, William J, P. Hewett, John L. Branden- 
burgh, Thomas A. Barlow, Henry Hannah, William Waldron, John Conover, Jacob Baker, 
Lewis B. Coy, Albert Lane, Ellis Jones, Wm. Van Wert, James B. Crofut, Roscoe K. Wat- 
son, Frederick Hunt, William Tuttle, Jotham Carpenter, Charles Wright, Sanford Olmstead, 
Fuller Carpenter, James Bentley, Robert W. Westcott, Jacob H. Byckman, John M. Bodine, 
James N. Hines, Edward Waldron, Warren Wright, David Baker, 

T. B. Lane, 1st Lieut. 38th N. Y. Vols. ; M. C. Larle, 1st Sergt. Co. D, l'7th K Y, Yols. ; 
Wm. Knight, Co. I, 6th N". Y. Artillery; Millard F. Lanning, Musician, 1st N. Y, Yols.; 
Wm. Ivenney, Co. R. Berdan's Sharpshooters ; Cassius Bishop, Co. E, 38th N, Y. Yols. ; 
Elliot See, Co. B, 38th N. Y, Yols. ; Daniel GiUis, Sergt. Co. B, 3d K Y. Yols, ; Caleb S, 
Frisbie, Co. B, 5th K Y. Yols, 

State of New York, Westchester Co,, ss, : 

I, William M, Skinner, a Notary Public, duly commissioned and sworn, residing in the 
village of Sing Sing, County and State aforesaid, do hereby certify that the names of the 
sixty persons subscribed to the Certificate hereto annexed, dated October 26, 1863, concern- 
the value and efficacy of Brandreth's Pills, beginning with Capt. John Yickars and ending 
with Caleb S. Frisbie, were signed in my presence, and that I, at their request, witnessed 
their signatures to said Certificate, 

I further certify that I am well acquainted with all who signed said Certificate, and 
know them, individually, to be men of truth and veracity. 

In witness whereof, I have hereunto subscribed my name and affixed my official seal, 
this eleventh day of January, one thousand eight hundred and sixty-four, 

WM. M. SKINNER, Notary Public. 

State of New York, County of Westchester, ss. : 

I, Hiram P. Rowell, Clerk of the County aforesaid, and also Clerk of the Courts in and 
for said County, do hereby certify that Wm. M. Skinner, Esq., whose name is subscribed to 
the Certificate of the Proof or acknowledgment of the annexed Instrument, and indorsed 
thereon, was, on the day of the date of the said Certificate, a Notary Public, in and for 
said County, residing in the said County, appointed and sworn, and duly authorized to take 
the same according to the laws of the said State, And further, that I am well acquainted 
with the handwriting of the said Notary Public, and verily believe that the signatiA'e to the 
said Certificate is genuine. 

In testimony whereof, I have herevmto set my hand, and affixed the seal of the said 
Courts and County, the 12th day of January, 1864, 

HIRAM P. ROWELL, Clerk. 

Cullen, William, M. D.^ First principles of medicine^ London, 

Fmers. 202. Fevers. — Sweating employed to pre Yent intermittent fevers, has 

ojieT '''dun- often changed them into continued fever, which is always dangerous. 

gerous. (^^ ^q^^ 

Urging the sweat, may produce hurtful determination to some of the 
internal parts, and may be attended with very great danger, (p. 166. f.) 

HoBEETSON, Robert, M. D., An essay on fevers, dhc. &c. JRobinson, 
1790. 



203. Idiopathic fever. — Whenever men complain of being seized 
with chilliness, or alternate chills and heats, headaches, sickness at stom- 



THE DOCTRINE OF PURGATION. 47 

acli, universal pains, or as the sick express themselves " pains all over 

them ; or pains in all their bones, or joints, especially in their loins and nf^Zerai 

back, with less or more debility ;" and if their countenance is at the same ^^«^«c«er-. 

time obviously diseased, whatever the other symptoms accompanying 

these are, I can, from experience, assure the reader, that a most virulent 

infection is present (p. 59). 

204. Whatever has a tendency to debilitate the system^ may either fe^'J^tg aJi 
be a remote or aproximate cause of fever, according to the constitution of ^J«^ ^^^^^' 
the patients. A sufficient reason may be assigned for many people being tem. 
seized with fever at the same time ; which is, their being exposed to the 

same debilitating powers of lieat, cold, draught, or wet, or sudden 
changes of these (p. 88). 

Miller, Edward, M, D., Inquiry concerning cutaneous perspiration 
and the operation and' uses of sudorific remedies. New Yorh, 1Y98. 
Medical Repository, 1798, Vol. II.; See Med. <& Phys. Journ. 1799, 
Vol. I 

205. That sudorifics can not he usefully employed as a general remedy pevers^x^ 
\b. fevers., \% apparent from the fatal course pursued by many of these not cured by 
diseases, notwithstanding the most copious, universal, and continued 
sweats, spontaneously taking place. The memorable sweating sickness, 

which first appeared in England, towards the close of the fifteenth cen- 
tury, and was one of the most fatal epidemics on medical record, affords 
ample proof of this position (Journ. p. 288). 

206. On the whole it may be concluded, that much of the use of Errors 
sudorifics has arisen from mistaken doctrines, concerning the nature of ^ ^\ng!^^ ' 
perspiration and of fever, particularly from the erroneous opinions, that 

the matter of perspiration is excrementitious ; that its occasional obstruc- 
tion is noxious ; that it ought as much as possible to be eliminated from 
the system ; and that it is only carried off, in considerable quantity, when 
discoverable by sight or touch (ibid). 

207. It may be also concluded, that sudorific remedies, especially 

those of the more powerful kind, are, in general, highly unsafe, and cal- umafl'^^^d 
culated to augiment the molence of infiammatory and malignant f eiders y ^^jtirious. 
and, that though they may succeed in some cases of less violence, or by 
a favorable concurrence of circumstances, yet they are so constantly 
liable to produce mischief, and exasperate the disease, that the abuse, on 
the whole, must be pronounced greatly to overbalance the use (ibid). 

Selle, H., M. D., Professor in the University of Berlin ; new con- 
tributions to physical and medical hrwwledge, Berlin, 1798. See Med. 
& Phys. Journ. 1799, Vol. I. 



208. Puerperal fever. — This disease originates in an accumulation of "?S 



Puerperal 
from 
ccv/mula- 



Gorrupted humors in the abdomen, which humors have either been al- *l^2 ""ImtZr 
ready separated in the form of milk, or intended by nature to be so. in the oMo- 



48 THE DOCTRINE OE PURGATION. 

The causes of this accumulation may be various, but are principall}^ an 
epidemic miasma, passions, sudden cold, and inflammation (Part III. 
p. 92). 



In corroboration of Professor Selle's theory, Dr. Hermbsteadt has 
proved by chemical experiments, that the fluid matter found in the cavi- 
ties of the abdomen was virtually rnilh. It deserves, however, to be 
remarked, that the fat of tlie omentum and the mesentery, being dissol- 
ved by the febrile heat, may combine with the extravasated lymph, so as 
to produce a fluid of a more or less viscid consistence, and resembling 
milk in its external characters (Journ. p. 387). 



Bache, William, M. D.. On a successful case of Asthma, Bvrming- 
ham,ll9d. Bee Med. & Phys. Jouen. 1799, Vol. II. 

209. I became convinced that an acid pervaded the whole of the 
'^eteS-etiol circulating system, and I presumed that it existed in a morbid degree, 
the cause, either as to quantity or strength, and was the exciting cause of the 
spasmodic affections observable m the lungs, and other membranous parts, 
to which it might occasionally be applied, probably sometimes in a gase- 
ous state, and at others in a more dense and concentrated one, and per- 
haps variously combined. The indications of cure suggested to my 
mind were to restrain its influence, and my attention was principally 
directed to the state of the stomach, the bowels, the expectorations, the Md- 
neys and the shin (p. 141). 



CoNEADi, D. G. C, M. D., Besiderit^ Physician at Nwthetm, Ger- 
many. Practical rema/rTcs on the most prevailing species of cramp, in the 
stomach. See Med. & Phys. Jotjkn. 1799, Yol. I 

210. The affection is not violent in the beginning, but a pressure, and 
Cramp in stricturc, and griping, rather than an acute pain, is felt in the region of 
*its*^ca5??' ^^ stomach. The patient has an oppressive sensation, as if something, 
neglect ^ of not uulikc a nail, were fixed behind the stomach : if the attack increases 
fiTe'cSeindi- in violcnce, he complains of stitches in the breast and towards the back, 
causl^^ *^^ and endeavors to procure relief by shifting his posture. The principal 
paroxysms are observed to take place generally in the afternoon, in con- 
sequence of bodily exercise immediately after dinner, the use of acid food 
and drink — and particularly after giving way to gusts of passion, such 
as terror, anger, grief, and anxiety. 

This affection is often contracted by persons subject to passionate emo-' 
tions, on their neglecting to take an emetic occasionally • it is not, in 
general, attended with acidity, but rather and most frequently is pro- 
duced by a bilious acrimony ; and it at length almost invariably degene- 
rates into a nervous habit (Jour. p. 49). 



THE DOCTRINE OF PURGATION. 49 

Denman, Thomas, M. D.^ On a ease of -dropsy in the ovariuwj. See 
Med. & Phys. Jouen. 1Y99, Vol. 11. 

211. After giving the history of a female patient, who had suffered Dropsy of 
from violent pains in her bowels, tension of the abdomen, and much iiomcollu- 
soreness on pressure, accompanied with vomiting, constipation, and fre- -P"^'^^- 
quent fainting, symptoms which were chiefly relieved by clysters and 
gentle purgatives, hemorrhages from the uterus, violent pain in the low- 
est part of the back, and, on pressure upon the sacrum or hip, in the 
neighboring parts. Dr. Denman says : There was great tension and pain 
above the " ossa pubis," and the whole hypogastric region was full and 
hard. She discovered a large hard tumor, extending to the right side of 
the navel, the increase of which w^as so rapid that in the course of a few 
days it occupied the whole abdomen. She was then freed from pain in 
all the parts contained in the pelvis, could lie on either side, and walk 
much better. She frequently after this had slight shivering fits, and a 
sense of coldness down her back, followed by restlessness and feverish 
heat, especially in her hands and feet in the evening, which went off 
with a free perspiration toward morning. Her pulse was at all times 
very quick.. Though one or more stools had leen regularly procured 
every day, an immense quantity of hardened faeces, of a large volume, 
were now discharged for three or four successive days, by which her size 
was much lessened. She had been treated for sciatica. When I first Regular 
visited her, the whole abdomen was distended by a circumscribed tumor wacuaTion 
springing from the right side, near the groin, thence extending across, fecir^ac^u- 
and high up in the abdomen, and I thought I could feel an obscure flue- ^uiation. 
tuation in it. 1 could also feel an angle of the tumor in the posterior 
part of the pelvis, by which the " os uteri " was projected so high and 
so far forwards as to be almost beyond my reach, as is the case in the 
retroversion of the uterus. She was not pregnant. I did not therefore 
hesitate in the opinion that it was a dropsy of the ovarium ; and by sup- 
posing this, early in the disease, to have dropped low down in the pelvis, 
and afterwards to have risen according to its increase, all the symptoms 
which had occurred could be satisfactorily explained. I directed only a 
strong purging draught. On the following day, she informed me that 
after suffering considerable pain in the bowels, she had four or ^yq 
copious motions, and that after every motion she was sensible of her 
size decreasing. The motions were unusually offensive, and, before they 
came away, the desire to expel them was unnaturally urgent and pain- 
ful. On examining them, I found that they almost wholly consisted of 
a gelatinous fluid, with many streaks of blood, and with little or no mix- anf^J^SJS- 
ture of faeces. Instead of feeling weakened by the evacuation, the lf'\g^'^*^^" 
patient felt herself very much relieved. The medicine was continued for 
two days more, producing the same number of motions ; the swelling of 
the abdomen had gone, the os uteri had descended into its proper posi- 
tion, and no tumor whatever remained in the cavity of the pelvis. I 
concluded that, in consequence of preceding inflammation, an adhesion 
had taken place between the cyst of the tumor and some part of the in- 
testine, probably the rectum, the adhering portion of the bowels had 
given way, and, by that opening, the contents of the tamor had been 
evacuated. She was perfectly restored to health (pp. 20, 22). 

Let the reader examine the Van Wart case at the end of these quotations. 



50 THE DOCTRINE OF PURGATION. 

IIexdekson, Stewart, Sicrg. Practical remarks on the diseases 
wli ich occurred on hoard of II. M. Ship Astrea, on the Jamaica station^ 
&c. See Med. & Phys. Joukn. 1799, Vol. I. 

212. Remittent or Marsh-fever. — This fever, the legitimate offspring 
f(vtT\x^ of all hot climates, especially where marshes abound, is the autumnal 
marsh efflu- ^^'^^^^^ ^f ^xLost parts of EuTopc, onlj appearing in a milder degree. It 
'"^^SE^FE- ^'^^ been described under various names — hilious^ yellow^ Jamaica^ Sene- 
TEK,"butun- gal^ and in Bengal, j?t^c^<2 — but multiplying distinctions which do not 
mldifica-^^''* exist only serves" to perplex and mislead, for it will he found to he the 
tions. same individual disease^ under different modifications^ depending on 

constitution, season of the year, and local situation. The cause of this 
fever, in all its varieties, is marsh effluvia. We find that in some places 
at the Cape of Good Hope, where no such cause exists, this fever is un- 
known. We likewise find that strangers are more liable to be afiected 
by this noxious effluvia, and have the disease in a more formidable de- 
gree, than the natives of the country, whose constitutions acquire a cer- 
tain power of resisting it from habitual exposure : at the same time, its 
effects on them are obvious, by shortening the duration of life. I do 
not think that the original disease produced by this miasma is infectious, 
but that it may alter its type and become highly contagious from con- 
current causes ; as from too many diseased bodies being crowded to- 
gether, without paying sufficient attention to ventilation and cleanliness, 
(p. 141.) This noxious exhalation enters the system either by the lungs, 
the skin, or stomach ; but the manner in which it produces those symp- 
toms of disease which characterize the fever does not appear to be well 
understood. We can only perceive its general effects on the system; 
and that it may lurk for a certain time in the habit before morbid move- 
ments take place (ibid). 

inCTeafrthe ^^^- ^^ ^ociqh uot bclow uor above the common standard of health, 
biuous secre- although there were marks of irritation and inflammatory diathesis, it 
gcSives^cBx- sccmcd uot Sufficient to justify blood-letting ; which I considered would 
ry It away, j^^y^ diminished the vital power. Antimonial emetics were not used, 
having always observed that they increased the irritahility of the stom- 
ach, which is the most troublesome symptom attending this form of the 
fever. I, therefore, thought it more advisable to employ mercurial ^w/'- 
gatives^ which had a very good effect in carrying off the hilious sordes 
collected in the fi/rst passages / emetics were sometimes given ; James' 
powder with camphor, to promote perspiration, and effect a complete re- 
mission (p. 143). 

Jfrom^coM ^^^- Pysentcry. This disease is not limited or peculiar to any cli- 
and wet ob- mate, uor is there any natural cause known to produce it : if it were oc- 
pe^pbation^ casioucd by any particular quality in the air, the natives, as well as sea- 
fn^ tbT flow ^6n and soldiers, would be attacked with it, but we find this is not the 
°l ^-^t^s *° case. For, when the dysentery was raging among the British troops at 
tines!^ the Cape of Good Hope, not one of the inhabitants were seized with it, 

nor is it a disease known among them. Whenever it becomes epidemic 
among the inhabitants of any country, it may always be traced to infec- 
tion introduced ; it being the constant attendant on camps, and the 
The cure scourgc of an army more destructive than any other enemy. I, there- 
^Ln^lT'the foi^e, consider it an artificial disease. Gold and dampness, when the 
m^h and "body is uot Sufficiently covered, by obstructing perspiration, and increas- 



THE DOCTKINE OF PURGATION. 51 

ing the determination of tlie fluids to the intestines, sometimes combined 
with febrile miasma, produce the whole phenomena of dysentery. In 
the treatment of this disease, I generally began with an emetic of ipecac- 
uanha ; bleeding was never employed, Uinless the patient was of a strong 
plethoric habit ; purges of salts or rhubarb with calomel were frequently 
repeated ; emollient injections and fomentations were of use, when the 
pains were wandering, and large blisters in every instance removed the 
pain where it was fixed (p. 23T). 

216. Diarrhma generally arose from relaxation brought on by eating ^.^urTti?'* 
unripe fruits, and committing other irregularities. It was easily re- cures. 
moved by lenient purgatives (ibid). 

216. Hepatic corrvplaints were brought on by violent exercise in the 

sun, joined to the abuse of spirits. Symptoms: pain in the side, some LimrCom- 
difficulty in respiration, pulse full and frequent, sometimes pain in the ^Se by 
shoulder, and about the region of the liver, which, when pressed, was at- «««''««^^<'«'- 
tended with a catching and troublesome cough. Bleeding, calomel 
purges, a blister to the side, sometimes mercury in small doses, were 
alternately resorted to, until health was perfectly restored (ibid). 

217. Spasmodic affections were mostly confined to the abdominal Cramp of 
mscera^ and brought on by lying on the deck in the night. The patients ^^^^tTuf*" 
complained of excruciating pain and stricture, commonly about the um- ^^emed *^^ 
bilical region, nausea, and sometimes vomiting. If fomentations did not 

cure the pain, a large blister was applied ; calomel with jalap taken in- 
ternally and clysters given, until stools were procured, which removed 
the complaint (p. 238). 

HuGGAN, A., M. i>., On the Croup, Plymouth, 1799. See Med. & 
Phts. Jofen. 1800 Vol. III. 

218. In a manuscript copy of the late Dr. Gregory's Zectures,! found Croup, 
a caution respecting hleeding in children, even with leeches, as apt to 
bring on fits. Now, if the learned professor's admonition was the re- 
sult of experience — and a case which I myself once saw, leaves me little un^^^dan- 
room to doubt it — what have we not to dread from taking blood away (Jfous in 
in a large stream from infants ? (p. 57.) . . . With regard to blood-let- altogether an 
ting in general, as a means of cure in inflammation, synocha, (&c., let me and'^^SS^ss 
ask, whence the necessity of diminishing the quantity of hlood in such F^ctice, in 
diseases f or what proof have we that the quantity of blood heing increas- TonlT'^'ew 
ed, — allowing, however, that it actually is ^o,—is the increase of it the ^^^"^^^/i?^^^*- 
cause of evil f By taking blood away we undoubtedly lessen the quan- 
tity of it, but do we really diminish the hulk of the circulating flu'ds, 

and contract the size of the bloodvessels f This is but doubtful ; for, it is 
more than probable that from the loss of blood the secretions are dimin- isfEVERNE^- 
ished, and absorption of moisture from the atmosphere increased, (p. cssary, sel 
58.) . . From the prevalence of bleeding in inflammatory diseases, some often hurt- 
have, either from prejudice in its favor, or from want of proper discrim- 
ination, used it copiously in genuine typhus, accompanied, as it some- 
times is, with thoracic pains, dhc. The result of such practice will be 
obvious (p. 59). 



FUL, SOME- 
TIMES FATAL. 



52 



THE DOCTRINE OF PURGATION. 



Upon the whole I think that I am sufficiently warranted^ from experi- 
ence, to draw the following conclusions respecting the use of venesection 
in the practice of medicine, viz. : That it is nevee necessary, seldom 

SAFE, often hurtful, AND SOMETIMES FATAL (p. 60). 

Miller, E., M. D., On the effects of Abstinence on the approach of 
Acute Diseases. See Medical & Physical Journ. London, 1799, Vol. I. 



Moderate 
7iai>its of 



p.'-e erve 
health. 



219. If the art of preserving health and prolonging life chiefly con- 
life p^revent g^gt in 2i frugal and sparing use of stimuli, and adapting them with cau- 
tion and skill to the fluctuating circumstances of the vital principle, we 
shall surely find still stronger motives to apply this doctrine at the ap- 
proach and in the treatment of diseases, when noxious powers of such 
preternatural violence invade the body, baffle every remedy, and stimu- 
late it to death. The regulations of this vital principle, here denomina- 
ted excitability, the preservation of it when present, and its restoration 
when deficient, the restraint of the excitement within the bounds of 
noLoderation, the prohibition of all wasteful and undermining excesses, 
will probably hereafter, at some more enlightened era of medicine, form 
a system of rules for the management of health and the prevention of 
disease, for the enjoyment of sense and the refinement of intellect, which, 
instead of the present feverish dream of human life, will present a con- 
summation of improvement and happiness which we now ascribe to su- 
perior beings (Journ. p. 45). 



Abstinence 



220. If I do not mistake, it has been proved, that abstinence will be 
of "Jir^aif- often a complete, generally a useful, and almost always a safe means 
TO ^s thrad- ^f obviating the approach of acute diseases. And, in a word, if it were 
vance of dis- possiblc to offcr to mankind a maxim of universal application to the 
treatment of incipient fevers, in all their variations and circumstances, I 
should be inclined to hazard the following aphorism : When symptoms 
denoting the approach of acute diseases are discovered, abstain, for a 
proper length of time, from all aliment (ibid). 



In the place of abstinence from all aliment, purgation is the method which experience 
has proved safe and effectual, both as a preventive and cure for acute or chronic or incipient 
affections. Brandreth's Pills and weak oat-meal gruel for a few days will do more good than 
abstaining from food, or half starving for weeks. And purging with these pills never weak- 
ens the vital forces, which cannot be said of the other plan. I think that the starving method 
is next in evil effects to bleeding. One takes the life out, the other prevents its renewal. 
It is effete matters, impure humors, floating in the blood or settling upon some organ, that 
cause all general or local disease. Purging takes these out, and, being done, the health is 
often restored at once. If you have poisonous matters about you, get rid of them as soon as 
possible. This is the sensible way. Starving does not get rid of them, it only reduces your 
life, your power to feel, that is all ; places you nearer the grave. While every dose of 
Brandreth's Pills takes the death principle away, and places a greater distance between the 
sick and the grave. 

I^ooTH, J., M. D., Superintendent- General of the hospitals in British 
America. Letter on the treatment of dysenteries and other autumnal dis- 
eases, to Dr. Mitchell, Quebec^ Jan. 24, 1Y99. See Medical Reposiiory, 
Vol. LL.p. 43Y, quoted in Med. & Phys. Journ. 1799, Vol. LL 



221. Having seen, in the course of my practice, a great number of 



((uti(/mnal 
disf.asefi — 
purr/ation 
the cure. 



THE DOCTRINE OF PURGATION. 53 

dysenteric cases, and having experienced the inefficacy, in g-eneral, of the 

usual mode of practice, I was induced to try the effects of the several and^*^otS 

purgatives now in use, with the view of ascertaining how far any one 

was preferable to the others, in the treatment of dysenteric patients. 

Experience soon taught me that the neutralized tartarit of potass was 

the most salutary in its effects ; and of course I have always, since that 

discovery, had recourse to it in dysenteries and other autumnal diseases, 

with the greatest success, hoth in children and adults (Journ. p. 181). 

Skkimshiee, J., M. D,, €ases of Fractured Skull, Wisheach, 1799. 
See Med. & Phys. Jouen. 1800, Vol. III. 

222. A boy four years of age had fallen from a height of ten feet Fractured 
upon a brick pavement. He vomited soon after he was taken up, and «^«^^- 
complained of a bruise on his head, but seemed otherwise quite well. 
There was a very evident depression of the right temporal bone, and 
fracture of the right parietal bone. Merely a spirituous embrocation 
and a gentle laxative was given. On the next day the depression was Purgatives, 
considerably less. Wo one had symptom had come on, but as the physic Wer^S^^-^ 
had not operated, I ordered an enema, took six ounces of blood from the boweis" ^rt 
arm, and ordered a strictly antiphlogistic regimen for three weeks ; in r'^j^ ' t^e 
ar few days the depressed bone had risen to its natural situation, and in toms aSS- 
a few weeks every trace of it had disappeared (Journ. p. 28). LndbriS^ 

Another boy, nine years of age, fell from a cart-horse upon a stone 
pavement and the wheel of the cart passed over his head. I found the 
whole left side of his head very much flattened, the temporal and great 
part of the parietal bone being very much depressed ; besides, there was 
a fracture of both bones, which crossed the squamose suture. The boy 
was comatose, but roused for a moment when spoken to. His breath- 
ing was laborious, pupils dilated, pulse of natural velocity, but intermit- 
ting. He had vomited several times, had hied much from the nose, and 
likewise from the right ear. Trepanning was proposed, but the parents 
objecting, the antiphlogistic plan was all that was left us. He, accord- 
ingly, was bled and an enema administered. The clyster had not oper- 
ated, neither a purgative given on the second day ; the depression kept 
on lessening, but the boy remained comatose ; another aperient was 
given, and on the third day a purgative enema produced a copious stool ; 
the symptoms abated, and disappeared after a repetition of the enema, 
the bowels now being opened (Journ. pp. 28-29). 

Suttoint, T., M. D., Considerations Regarding Pulmonary Consumption. 
London, 1Y99. See Med. and Phts. Joijkn., 1801, vol. YI. 



223. The^^^ symptoms of disease were in the howels, and by degrees 
the disorder became a confirmed phthisis pulmonalis. Hence I was led uon'^^o- 
to suspect the emaciation and dehility to he induced hy some disease of sympathy 
the oMaminal viscera, which, however, I could not account for in any ^X^ofthe"" 
other way except by supposing the mesenteric glands to be obstructed, ^^^f/f'^^J^ 
as the symptoms led to no suspicions of any other cause or causes that ^^SeLr"^ 
could be considered as adequate to produce such effects. I have seen 2/yf ""^^^^ 
several cases where affections of the howels preceded the pulmonic symp- 



Consfunvp' 



54 



THE DOCTRINE OF PURGATION. 



Purgatives 
and emetics 
cure. 



to?ns. It is a very common thing for patients, in protracted d/i/senteries, 
to have jpul mom c affections hefore death ; and it frequently happens that 
diseases of the abdominal viscera are, in tlieir latter stages, accompanied 
by pulmonary consimiption. By writers on this disease the ."tabes me- 
senterica " is mentioned as sometimes accompanying it. . . Hence, it ap- 
pears to me that phthisis pulmonalis is caused hy a disease in the mesen- 
teric glands, and that the tubercles in the lungs, and some other of its 
symptoms, are excited by sympathy (Journ., pp. 89, 90). 

"224. For, an increased action may be produced by exciting an in- 
creased motion in the contiguous parts, v^hich may be effected by the use 
of emetics and purgatives, which promote a greater motion in the intes- 
tinal canal, and, from their contiguity, in all probability, communicate 
some of it to the mesenteric glands (Journ., p. 90). 



Hydroce- 
phalus, like 
all dropsies 
caused by 
an abun- 
dance of 
fluids which 
cannot be ab- 
sorbed. 



Purgatives 
remove the 
cause of 



disease. 



White, W., Sm*g., Remarks on Hydrocephalus Internus. Bath, 1Y99. 
8ee Med. and Phts. Jouen., 1800, vol. III. 

225. Case of hydrocephalus given. He took small doses of calomel 
combined with digitalis. As purgatives produced no effect in stimula- 
ting the intestines, clysters were resorted to for that purpose. After a 
fortnight, evident symptoms of amendment took place, and he soon re- 
covered (Journ., p. 113). Dr. Whytt, to whom we are greatly indebted 
for a very minute description of the symptoms usually attendant on the 
disease, observes : '' The immediate cause of every hind of dropsy is the 
same, viz., such a state of the parts as makes the exhalent arteries throw 
out a greater quantity of fluids than the absorbents can take wp.^^ Which 
state, from what he afterwards mentions, he evidently considered as con- 
sisting in debility (p. 117). Purging is -necessary, not only on account 
of lessening the determination to the head, but particularly as the symp- 
toms, which proceed merely from fullness in the stomach and bowels, 
have been frequently soon removed by evacuating the bowels (p. 119). 



Caesok, William, M. D., Letter on the Applicability of Mercurial Prep- 
arations in Children'' s Diseases. Birmingham, 1800. See Med, 
AND Phys. Joukn., 1800, vol. IV.- 



226. For several years I have been dissatisfied with the general and 
indiscriminate use of calomel in the diseases of children ', I am not more 
certain of any one fact that pertains to medicine than that I have seen 
many children who have fallen a sacrifice to the improper application of 
this medicine. Calomel, when mixed with susrar, forms a medicine 



Inf'imMle 
diseases. 

Quomei ^jf^jg meaicme. vjaiomei, wnen mixea witn sus^ar, 

never safe ' O " 

in minute agreeable to the palate of the child ; its exhibition is easy to the mother 
a^poilon.^"^^ or nurse, and it may with safety he cfiven as a purge, when a pur^e is 
indicated. 



gwen as a purge, wnen a purge 
When given as a purge, its action is confined to the first pas- 
sages ; but when the dose infrequently repeated, either for the purpose of 
obviating habitual costiveness, or with any other intention, it is absorbed 
by the lymphatics, and enters the system, by the action of which it is de- 
composed, . . . and that state of the system produced which is called 
mercurial fever . Although mercury does not appear to have so power- 
ful an action on the salivary glands of children as it has on adults, yet 
I apprehend its general effects upon the system are greater. The mer- 
curial fever in adults soon runs into indirect debility. 



THE DOCTRINE OF PURGATION. 55 

227. The injurious consequences likely to flow to children from the 

high degree of excitation and extreme succeeding debility produced by cephliu8'\& 
a mercurial course I wish to impress upon your readers. Mercury has '^auced thtm 
been erroneously held forth as a specific in hydrocephalus, and is often cured or pre- 
given as a preventive of that fatal malady. Hydrocephalus appears to merluri/. ^ 
be the result of debility succeeding too high an action of the vessels of 
the brain. If so, can any medicine more powerfully produce hydro- 
cephalus than mercurial calces? (Journ., p. 411.) 

Chapman, John, Sur., Oases of Injuries of the Head, with Observations. 
Amjpthill, 1800. See Med. and Phys. Journ., 1800, vol. III. 

228. The fondness for trepanning, so much inculcated by Mr. Pott, 
and so very anxiously supported by Mr. Benjamin Bell, has justly met 
with two very able antagonists in Mr. John Bell and Mr. Abernethy (p. 
31, Journ). Every man, previous to applying the trepan, ought to ask 
himself for what he is going to trepan ? " To think that a fractured 

skull is a chief cause, or even an absolute sign of danger, is a very erro- inivjwries 
neous notion ; it is not the damage done to the skull, but the injury to ^/ J,'^^ ^^«^. 
the brain, that is the cause of danger ; and the fracture of the skull is operation 
but a faint, uncertain mark of the harm done to the brain " {J. BelVs ^"^t^ft^^ 
Discourses on Wounds of the Head, p. 137). Again : " There is still '^{tngX^ 
but one motive for applying the trephine, viz., to relieve the brain from v^rge, and 
compression" (ibid., p. 144). tefmile, the 

N^ow, I am speaking of aifections of the brain, I cannot forbear ob- ^ITLcS.^^ 
serving that I have long been dissatisfied with the Edinburgh treatment 
of concussions of the brain, viz., with cordials, wine, and stimulants. 
My ideas on this subject are so exactly consonant to what has been said 
by Mr. Abernethy {Surgical Essays, vol. HI, pp. 59, 60), that I shall 
therefore refer my readers to his Essays (Journ., pp. 33, 34). iV. B. 
Abernethy employs purgatives, bleeding, and antiphlogistic regimen. 

FowLE, William, M. D., ^ Practical Treatise on the Different Fevers 
of the West Indies, and their Diagnostic Symptoms. london, 1800. 
See Med. and Phys. Jouen., 1800, vol. IV. 

229. Very early after my arrival in the country I observed thsit per- 
sons attacked with fevers, in almost any situation, very generally became Yeiiow/e- 
YELLow. This soon led me to conceive it merely a concomitant symptom, InautT^^' 
and by no means such as could be sufiicientlv characteristic of anv one .^^hout par 

/> ^ - . '11 •• -iiT T "^ ^J^iv> ticularmean 

lever to give it a particular denomination ; it also led me to discover the i^g-the dis 

cause of the variety of symptoms attributed by different authors to the 

yellow fever, and to account for successful methods of cure which were 
often diametrically opposite to each other. The longer I remained in 
the country the more I was convinced of the danger attendant on giving 
a name to one disease from a symptom common to so many (Journ., p 
355). 

Dr. Fowle divides the fevers of the West Indies according to their 
appearances into intermittents, remittents, ardent fever, and the malig- 
nant or jail fever. 



ease a com- 
monfever. 



56 THE DOCTRINE OF PURGATION. 

GeoghegA]!^, Edward, Surg., On Strangulated Hernia. Dvhlin^ 1800. 
See Med. and Phys. Journ., 1800, vol. lY. 

230. Let us for a moment consider the state of the parts : A portion 

of the intestine lies without an aperture, through which it is too large to 

tfdhenii^a.' P'^>5S ; the qucstiou then arises, what occasions its bulk ? Surely, the 

tUic^^of'l\xe i^^ture of the part, the touch, and all the circumstances of the case, 

case indicat- clcarlj evince it to he flatus^ and sometimes together with excrement and 

uon!'^''^^"''^' an inflamed intestine^ ^^\\o^q functions are so far deranged that it cannot 

act upon its natural contents^ so as to move them in their ordinary 

course. . . Nothing can be more obvious than that every effort should 

be made to lessen the hulk of the hernia, and none to push it through 

the ring ; it will pass in of itself after the air has been extracted (Journ., 

p. 318). 

Purging with Brandreth's Pills is what is needed. 

Magennis, J., M. D., On Epilepsy. Birmingham., 1800. See Med. 
AND Phys. Journ., 1800, vol. lY. 

Th?to?^or 231. I observed in these patients, and in most others who have long 
ach^and^S- l^borcd uudcr this untoward disease, a dullness of apprehension, a par- 
testines re- ticular s^arc and vacuum of countenance, a dilated pupil, and an inabil- 
^fui ^^^ ity of the iris to contract on the admission of light, accompanied with 
purges.^ stupor and a general irritability of the muscular fiber. This torpor ex- 
tends to the stomach and intestinal canal ^ as those people subject to the 
disorder usually require the most active cathartics and emetics to excite 
the primse viae into action (Journ., p. 419). 

Reeve, R., Surg., On a Successful Ca^e of Hydrocephalus. See Med. 
AND Phys. Journ., 1800, vol. III. 

232. Hydrocephalus internus. — The author's own child, at the age of 
eight months, in December, 1798, could stand alone, and had every ap- 
pearance of a healthy, forward child. His temper was unusually placid. 
Case of and his spirits invariably good. Towards the end of the month he be- 
cephaius^"' came extremely costive, and though medicine for a time relieved him, 
"^^eceZity^ot ^^ was frequently and violently seized with pain in the abdomen, which 
full contin- ^vas generally mitiarated by a clyster. . . He ceased to ^row, except the 
fui '' purga- head, which, towards the end of January, 1799, was perceptibly increased 
^^^ntestinai^ in sizc, and his costiveness was become so obstinate as scarcely to yield 
canal. to the Hiost active purgatives. It was this singular state of the alimen- 
tary canal, which had existed upwards of six weeks, that first led me to 
suspect some material derangement in the state of the brain. On the 
12th of February he was convulsed in the night, took antimon tartaris 
in small doses, with little or no effect, and on the following day castor 
oil, which was repeated a second time, before any motion was produced ; 
the abdomen was very hard, and of an extraordinary size; the stools of 
a clay color, and of such an adhesive nature that they could not easily 
be separated from his napkins ; his urine high-colored, secreted in large 
quantities, and gave a yellow tinge to his linen. James' powders were 
given, but fever and delirium set in, with a voracious appetite, and all 
the symptoms of hydrocephalus. Calomel given as purgative in the be- 



THE DOCTRINE OF PURGATION. 57 

ginning of March was charged with mercurial friction, but all hope of 
his recovery was lost ; he cried much, had much pain in his bowels, 
which were distended by flatus to an alarming degree, and the only relief 
that could be obtained was by clysters. A blister that was applied to 
the anterior fontanelle was kept" open and discharged copiously, and in 
April he commenced slowly to recover. . . ISTow his bowels are quite 
restored, and he has left off all medicine (Journ., pp. 61-64). 

Brandreth's Pills could have saved all this pain and suflFering. 

UNwms, David, Surg., On Febrifuge Medicines. See Med. and Phys. 
JouEN., 1800, vol. IV. 

233. A derangement of the nervous system, occasioning general de- Femr. 
lility, is an invariable attendant oji fevers of every denomination^ and to b^^onb fe-^ 
this single cause, dehility. are all the svmptoms which occur under differ- ^^r," one 

• •> X CG'tCS^ but 

ent circumstances of constitution, situation, habit, &c., of the patients different 
to be referred; for, notwithstanding the minute division and extensive tiona^^^^^*^' 
classification which have been adopted by nosological and systematic 
writers on febrile affections, there appears to be no sjpecific or abstract 
difference in the diseases themselves^ the variety of appearance w^hich they 
assume being totally dependent upon the state of the constitution receiv- 
ing the affection. Thus, the same causes operating upon a person of a 
sanguine temperament and plethoric habit will occasion the disease 
which has obtained the appellation of inflammatory fever., with symptoms 
of vascular excitement, which, on a patient of a contrary description, 
will be productive of a typhus or nervous fever (p. 64). 

234. When the quickness, smallness, and irregularity of arterial pul- thfconsSt- 
sation, distressing pains in the head, extreme oppression of the mind, s^^f^o^^^^g^ 
and other symptoms are present, denoting the highest state of nervous moved, 
debility, a dose of powdered antimony, in such quantity as to create a sympath*yf^ 
slight nausea of the stomach, will often reduce the pulse to its proper %^^^'"^^^' 
standard, and, by inducing a regularity and due proportion between the stomach. 
action and reaction of the system, will effectually arrest the further pro- 
gress of the disease. 

Woodward, W., Surg., On Infantile Diseases. See Med. & Phys. 
JouKN. 1800, Vol. IV. 

235. There is a liquor in the bowels of infants and many other ani- 
mals, when they are born, which is necessary to be carried off ; the medi- infanuu 
cine which nature has provided for that purpose is the mother^ fl/rst ^ The^mW^- 
milk ; this, indeed, answers every purpose, and effectually; but we ^""^f^g ^j^/^* 
think some drugs forced down the child's throat will do much better — meaidne. 
the composition of which varies, according to the fancy of the good 
woman who presides at the birth. . . . We see that notwithstanding the 

many moving calls of natural instinct in the child to suck the mother's 
breast, yet the usual practice is to deny that indulgence till the third day 
after the birth ; by that time, the suppression of the natural evacuations 



The natu- 
ral t vacua 



58 THE DOCTRINE OF PURGATION. 

of ilw m ilk usual] J hriiujs on a fever ^ tlie consequence of which is often 
fatal to the mother^ or puts it out of her power to suckle tlie child at 
'ind^Ture? ^^^^^^ time. The sudden swelling of the breasts, which commonly hap- 
miik-fever. pens about the third day, is another bad consequence of this delay. 
When the breasts become thus suddenly and greatly distended, a child 
is not only utterly unable to suck, but, by its cries and struggling, fa- 
tigues and heats both itself and the mother ; this is another cause which 
prevents nursing. . . . The gentlemen of the Lying-in-Hospital in Lon- 
don ordered the children to be put to the mother's breast as soon as 
they showed a desire for it, which was generally within ten or twelve 
hours aftei' birth ; this rendered the usual dose of physic unnecessary ; 
the milk-fever was prevented ; the milk flowed gradually and easily 
into the breasts, which before were apparently empty, and things went 
on in the natural way. If a mother is determined not to nurse her own 
infant, she should, for her own sake, suckle it at least three or four 
weeks, and then wean it by degrees from her own breast. In this way 
the more immediate danger arising from repelling the milk is prevented 
(pp. 43-44). 



The miai 236. There is, in truth, a greater luxuriancy of life and health in 

energy i" - - - ■ - ' . ^ .. -,„«/ , ._ 

children 



infancy than in any other period of life. Infants, we acknowledge, are 
£^aduit?^° more delicately sensible to injury than those in advanced life ; but to 
bleeding compcusato this, their fibres and vessels are more capable of distension, 
riout to'"^iC their whole system is more flexible, their fluids are less acrid, and less 
Ser^^^^^ disposed to putrescence ; they hear all evacuations niore easily^ except 
that of hlood ^ and, which is an important circumstance in their favor, 
they never sufler from the terrors of a distracted imagination. . . . 
Children recover from diseases under such circumstances as are never 
survived by adults ; if they waste more quickly under sickness, their re- 
covery is quick in proportion and more complete than in older people ; 
in short, a physician ought never to despair of a child's life while it con- 
tinues to breathe (p. 43). 



MooEE, James, Surg.^ A case of Synocha^ London^ 1801. See Med. 
& Phys. Joijkn., 1801, Vol V. 



Synocha , /,.-,. . -, . 

is a common 237. Synoc/ia, OY fUTC %nflaifnmatory fever ^ is a disease so rare m this 

oPhigh'^dl- country that many experienced practitioners have doubted its existence. 

Stion°^ iTd Here follows a case : — The treatment employed during the Ave days he 

longer dura- ^g^g uudcr uiy chargo consisted simply of two purgatives, and a draught 

of one-fourth of a grain of tartar emetic, and two drachms of the acetate 

Pwrgation. ammouia water, which was exhibited regularly every six hours. (Journ. 

p. 233.) 

Synocha certainly very much resembles the symptomatic fever at- 
tendant upon phlegmon ; the common ephemera is undoubtedly of the 
same species, and the synocha seems to be precisely the same malady, in 
a more violent degree, and running on for a longer period, (ibid. p. 234.) 



n>/dro- 



THE DOCTRINE OF PURGATION. 59 

pRicARDS, J., Surg., On Ilijdrocephalus, Brentford, 1801. See Med. 
& PiiYS. JouKN., IbOl, Vol, v. 

238. Case of a boy, 8 years of age, strong purgatives given : This 
produced verf/ brisk evacuations at each time of repeating it (every other 
morning) ; after each repetition, however, he appeared better and more rnued ///'/•- 
lively. The plan was continued for several weeks, during which every ^'^^^.l^^^Jjil 
symptom of the disease gradually subsided, until his pristine state of «'^'' ^.^^ "'■ 
health was completely renewed. (Journ. p. 344.) weakenrtL 

Therefore it appears to me, that drastic ^purgatives, frequently ad- ^^^^^'^^ 
ministered, have a much fairer chance of success by increasing very pow- 
erfully the action of the absorbents, while they do not produce that debility 
of the system which is the consequence of mercury (ibid. p. 345). 



Savaeesi, Antonio, M. D., Physician to the French Army in Egypt, on 
the Cure and Prevention of the Endemic Ophthalmia of that Coun- 
try. Transl. by G. Plane, M. P., London, 1801. See Med. and 
Phys. Jouen., 1801, vol. VI. 



239. Pr. Savaresi first divides this complaint into the sthenic and 
asthenic ; the one depending oif an excess, the other on a defect, of tone. Ophthalmia 
The former effects the bulb of the eye ; the latter sometimes the " sar- ?ieties!^ ^*" 
sus," sometimes the "tunica conjunctiva." j^sfremedy 

In the beginning I purge in all the three species, without distinction, "po^^ ^^^^ 
with an ounce of magnesia vitrolata, otherwise called Epsom salts. The v^^Xs. 
sthenic ophthalmia requires very close and strict attention, inasmuch as 
the cure depends on the efficiency of the first remedies. After this, top- 
ical remedies, as emollient colly ria, are employed, and low diet. 

As preventive, he recommends avoiding exposure to the sun with the 
head uncovered, and to the night dew, abstaining from salted food, avoid- 
ing cold after being heated, and attention to the intestinal evacuations 
(Jonrn., pp. 357-359). 



Tainsh, W., Surgo, Accoimt of Some Cases of the Plague, which occur- 
red on board of a British ship-ofwar on the coast of Syria. See 
Med. and Phys. Journ, 1801, vol. Y. 



240. Plague. — Mr. Tainsh employed, after removing all clothes 
from the patients, and washing them with soap over the . whole body, 
powerful repeated evacuations of the bowels by emetics and laxative clys- 
ters. The sick used to discharge "«^ enormous quantity of bile, viscid Td Imfcwi- 



Plcigue.. 
Potverfnl 



sordes, and tough phlegm,^^ 2,u.di the stools gave the sick evidently much thfcau^r 
relief; when a bitter taste and nausea continued, emetics were repeated, 
which cleared the stomach of a large quantity of disagreeable matter, 
which gave great ease. After thus removing the cause of the disease, a 
strengthening treatment was pursued, and the buboes treated by poul- 
tices (Journ., pp. 539-541). 



60 



THE DOCTRINE OF PURGATION. 



Yage, T., M. D., CnMoisms on the Ireatment of Venereal Di 
London^ 1801. See Med. and Phys. Joukn., 1802, ml. YIII. 



211. Opiates are usually and properly given, in the intention of 
Opium re- mitigating severe pains in tlie venereal disease ; but, notwithstanding 
♦wrrajw sy.^- their utilit}^, a free and frequent use of them always induces a relaxation 
'^']Siu1sbes^^" of the system^ and debilitates the chylifio orgaris, which are primary things 
to guard against in mercurial courses. Although both these effects of 
opium appear to spring from one common source, by producing a ner- 
vous, sedative stupefaction, yet some observation in practice inclined me 
to suppose that ease may be procured without any concomitant debility 
(Journ., p. 8). 



ckylijica- 
turn. 



212. Ifercury, however, with all its anti-venereal properties, is natu- 
Mercury ^<^^2/ inimical to the nervous system^ and exerts its injurious effects, in 
breaks some de2:ree or other, in the most judicious use of it. When it is ex- 
hibited too copiously, and suddenly, it is apt to produce violent eiiects, 
as great sioelUng of the head and tongue^ apoplexy, &c., because it breahs 
down the Mood before any outlet is prepared for its evacuation. When 
its use is gradual, these effects will be moderate, but they will accumu- 
late in time to considerable injuries of the same nature. The most vio- 
lent and mildest effects of remedies are produced upon the same princi- 
ple., and the former are frequently the cfnly index to explain the latter,- 
which would otherwise be too minute for observation (Journ., p. 9). 



d(nc7i the 
blood 



Axiom. 



The two 
causes of 
mercurial 
disease. 



Parallel 
between 

lead and 
mercury. 



213. The infirmities which arise from the use of mercitry appear to 
originate y^m two principal sources: one is its dissolution of the hlood, 
by which a redundance of serum is forced into the interstices of the cel- 
lular substance of the muscular, vascular, and nervous systems ; in con- 
sequence of which the gluten, which gives strength and stability to the 
solids, becomes relaxed, and the different functions of the animal economy 
so debilitated as to be incapable to be properly actuated by the nervous 
influence, while the nervous system itself may remain in a tolerable 
condition. The other source of infirmity, on the. contrary, is when the 
nervous system has heen left impaired and cannot invigorate these func- 
tions, which may not have suffered any considerable detriment. For, it 
is experimentally ascertained, that if the nerves of any part are injured, 
either at their origin or in their course, that part will become propor- 
tionally inert in its office (Journ., p. 9). 

The effects of mercury are somewhat similar to those of lead ; both 
have power to produce paralytic affections ; both, in a weaker degree, 
abate inflammations and mitigate pain ; and the imbecility of both re^ 
main after they have been quite expelled from the habit (Journ., p. 10). 



211. In considering the dyspeptic symptoms of this or any other dis- 
Dyspeptic casc, it appears to be generally conceived that the cause of them is the 
ivomsyZpa- wcakucss of the stomach alone. This opinion has probably led to some 
^\h ^intT^ important mistakes in practice ; for this organ is not less subject to be 
tines&n&the affcctcd by causcs, and the condition of parts remote from itself, than it 
whole ays- ^^ capable of affecting the whole system. Thus an indolence of the in- 



Hon. 



THE DOCTRINE OF PURGATION. 61 

testines, or a diminution pf their action in any part^ from the pylorus to 
the rectum, will produce nausea and indigestion^ even when the stomach removT^thl 
itself may be in a good condition ; and hence it is that often a cathartic amSSt- 
will remove tliese symptoms by giving an additional irritation to tlie «^«^ intesH- 
obstructed and enervated parts. In general, however, here the stomach promoting' 
participates of the mercurial debility^ and corroborating aperients be- uonoi^good 
come requisite. In regard to the inertness of the intestinal action, it ciyiificJ^^ 
may be further noted that it frequently proceeds from a deficiency of the " 
hile^ which a cathartic stimulus is likely to prevent, for undoubtedly this 
secretion depends much upon the proper action of the duodenum. But 
the chief utility of the bile results from its chylific property, which ap- 
pears to consist, in a great measure, of mixing the oily and aqueous 
parts of the aliment, and assimilating them into a uniform liquid. 
This great importance of the hepatic secretion^ whenever it appears de- 
fective^ demamds immediate assistance hy active purgative medicvne (p. 
'172). 

A.iJLD, Isaac, M. D., of Edisto^ S. O., Case of Acute Bilious Fever read 
hefore the Medical Society of South Carolina, 1802. See Med. an-d 
Phts. Jouen., 1808, Vol. XIX. 

245. Case. — A young man who had spent a month in the country, 
on the morning after his return complained of slight chilliness and a ious^'/t... 
dull pain at the pit of his stomach, which soon after terminated in exces- iow"^^?ever) 
sive vomitina, violent fever, and intense pain in his head. These symp- symptoms: 
toms continued without abatement until about three o'clock in the preceding 
afternoon, when they suffered considerable remission. At this time I 
saw him. I found that so general a suffusion of l)ile through the System 
had taken place as to resemble a person laborinp; under iaundice, with ^head and 



Acute hil' 



and attend- 
ing, fere)- 
and cJiills, 
pains in the 



stomach, 



the exception of the eyes, which were slightly inflamed. His bovv^els ^vomiting, 
were obstinately bound, having been in a state of constipation for the 
two or three previous days. His tongue was moist, the edges inflamed, 
the top white, excepting the middle, down which ran a yellow streak 
(Journ., p. 106). 



Cure : 
P'noerfnl 
purg Hon, 
removing 



246. Treatment. — As his pulse, which was slow and irregular, seemed 
now to forbid the lancet, though there was still some pain in the head, 
and costiveness and debility appeared to be the principal inconveniences 
under which he labored, I contented myself wdth leaving for him tivo 
smart purges of calomel and jalap, with directions to take one immedi- the cause 
ately, and the other in four hours, if the first did not procure eight or muiation'oi 
ten copious stools. On visiting him again, about nine o'clock, I found ^J"/' J^i3 
that he had taken both his purges with the happiest eflect ; they w^ere then f^<^^^- 
operating briskly, and had already produced several large evacuations of 
hard, darh, and very foetid fmces. The pain had entirely left his head, 
his pulse had become regular and more full, a gentle moisture had over- Natural 
spread his skin ; his stomach had recovered much of its usual tone, and 
this was accompanied with desire for food. On the next morning he had 
left his bed with an assurance that he felt himself quite free from indis- '[abloiuteiy 
position. The discharges from his bowels were still kept up, but had Tcf'ionof^t^l 
entirely lost their foetor, and appeared to consist chiefly of healthy-look- P^Jfeatment. 



stools suc- 
ceeding mor- 
bid evacua- 
tions do not 



6-2 



THE DOCTRINE OF PURGATION. 



ing bile. Ilis skin liad become much clearer, as bad bis urine, wbicb 
before was of a deep bilious bue. 

I suggested tlie propriety of bis taking gentle purgatives for a day or 
two longer • hut this advice^ from tbe comfortable state of bis feelings, 
he declined^ and I, of course, left bim. On tbe tbird morning after this* 
Aicfuicon- ^ ^"^^ ^^^* ^^^' ^^ attend in all possible baste, as tbe patient was supposed 
^^hn'^V'^'f ^^ ^^ ^.y^^g- I found bim speecbless, bis jaws were fixed, as also were 
purgaimi. liis cjes, wliicli wcrc nearly closed ; be bad no pulse at tbe wrists, bis 
feet, legs, and knees were perfectly cold, and bis stools, wbicb were black 
and very oifensive, came from bim involuntarily; bis breathing bad 
been very laborious, but now it appeared to be free from anxiety. I was 
informed that tbe day I left bim tbe pain in bis bead and tbe fever bad 
returned witli its former violence, and bad continued without any dimi- 
nution until this morning, when it terminated in tbe comatose state de- 
scribed. The cure was hereafter effected by nitric acid and blisters, 
which restored the vitality of the patient, and by a continued applica- 
tion of that acid and strong purgatives, which carried off large masses 
of very foetid, hardened faeces (Journ., pp. 106-109). 



Eruptive 
disease of 
the head. 



Physiology. 



Badgek, John, Surg., On a singular hind of Erujptive Disease. See 
Med. and Phys. Journ., 1802, Vol. YIIL 

247. The first opportunity of witnessing this disease was at Putney, 
in tbe month of July, 1801 ; it seemed to be confined to children only 
of a certain age, having never seen a child affected with it before seven 
nor after fifteen years, though equally exposed, as it was evidently infec- 
tious to them. It commences with a slight fever, which continues three 
or four days ; it then increases ; nausea, and sometimes vomiting, attend 
(in one or two instances I have observed the patients to complam of vio- 
lent sickness after they were put to bed), with pain in the head and 
loins ; it is then succeeded by an eruption containing a well-matured 
pus ; the pustules are large and very thick about the head, resembling 
those of small-pox ; and in every case I have seen they have been con- 
fined to the head, particularly to the scalp. Tbe bowels during the jpro- 
gress of the disease were umtsually constijoated^ and, in one or two in- 
stances, not only tbe body but the face likewise was much swelled. Tbe 
first two or three cases I bad not an opportunity of seeing till after the 
eruption had taken place to a great extent, covering almost the whole of 
tbe scalp. • 



Treatment 
by cleanli- 
ness^ with 
spare diet 
and purga- 
tion. 



24:8. The hair was shaved ofi" as close as possible, tar ointment and 
a mild purgative applied ; but this treatment produced no amendments, 
the ointment rather increasing the number of pustules. I ordered, there- 
fore, the bead to be kept clean with warm soap and water, the patient 
to use a spare diet, and the bowels kept open with an active purgative 
once or twice a week, or " pro re nata," and a few drops of antimonial 
wine given once in four or six hours, till the feverish symptoms had sub- 
sided. This plan was pursued for several days without having at all 
mitigated the complaint, though it seemed, undejr every circumstance, to 
be the best mode of treatment that could be adopted. Accordingly it 
was continued for a few days longer, at which period the pulse became 
regular, tbe pain in the head and loins was removed, the pustules began 



THE DOCTKINE OF PURGATION. 63 

to dry off, and in about a week the complaint entirely ceased (Joum., 
pp. 106, 107). 

CuEEiE, William, M. D., Observations on the Treatfrnent of the Malig- 
nant Yellow Fever ivhich prevailed partially in the City and Liber- 
ties of Philadeljphia in the summer and autumn of 1802. Phila- 
delphia, 1802. See Med. and Phys. Jouen., 1803, Vol. IX. 

249. Merciory was generally employed both internally and externally 
for the purpose of exciting salivation as speedily as possible, both at the Yeiioio/e 
hospital and in private practice ; bnt, if I can trust my observations, 
seldom with success, excepting where employed at the very commence- 
ment of the disease, and so conducted as to affect the mouth before the 
dangerous symptoms of the second stage had time to make their appear- 

Mercury 
'^^^^^' ^ ^ seldom use- 

When employed in the second stage of the disease, at which time the -^fiL^^ta^^^ 
predominant symptoms are generally disordered stomach, restlessness, op- auninteiy 
pression, and deep sighing, and a countenance that denotes great misery, JJ^^"'^^"^'° 



ver. 



stage 



move the 
worst symp' 
■ toms. 



it constantly aggravated the disease, and hurried on the fatal symptoms 
of hlaclc vomiting. 

In this stage of the disease, when the recited symptoms predomina- 
ted, the frequent exhibition of mild laxatives in small doses, particularly 
Rochelle salts, soda phosphorata, soluble tartar, castor oil, senna, and ^Y,^^*^?- 

n 111 11 iii'Ti .' and i"a;«rz /./ 

cream oi tartar, and when these could not be obtained, laxatives and ^'^"-^^ x.^- 
clysters, were the most successfid remedies, especially when aided by 
blisters to the stomach, wrists and ankles, at the same time. 

A solution of carbonate of soda in water, which is much more pal- 
atable than the vegetable alkali, followed immedia,tely by a tablespoon- 
ful of diluted lemon juice, or cream of tartar in water, had also some- 
times the effect of allaying the distressing propensity to puke. But 
these, as well as every other means that I have seen tried, too frequently 
failed of affording relief (pp. 98, 99 Journ.) 



[If mild laxatives were frequently apt to allay the worst symptoms, 
it is reasonable to expect complete success from active purges?^ 



250. In this state of the stomach the internal' use of mercury, either 

alone or when combined with opium, always increased the distressing and^opium 
propensity to puke ; and, when it failed to operate by stool, it aggravated ^^f "f ^^^ 
every symptom of the disease (Journ., p. 100), toms. 

251. In cases where the disease began with strong action of the arte- 
ries, severe pain in the head, bach and limbs, with little or no sickness at Active 
stomach, bleeding, purging with active medicines, and the strict observ- ^22'"* 
ance of every part of the antiphlogistic regimen, generally occasioned ^yitii ^epie- 
a partial solution of the fever on the third, and a complete solution on 

the fifth, day from the attack (Journ., p. 101). 



04 THE DOCTRINE OF PURGATION. 

TTeberden, William, M. D., Commentaries on the History and Cure 
of Diseases. Lcmdon^ 1802. 

252. A diarrhoea arises from a variety of causes, most of wliicli are 
void of all danger, and are easily removed. It is often hrought on 'by that 

marrJuva P^iver which is exerted in every part of the body of freeing itself from 
Nature's wa'y anything jpainf id and oppressi'iie. Not only the mischief from the nox- 
ious qnalities and improper quantities of what has been taken, and im- 
mediately offends the stomach, are carried off by means of a diarrhoea^ 
but liheivise many disorders of remote parts or of the whole body are, 
by the self oorrecting powers of an animal body, determined to the bowels, 
and thence discharged by diarrhoea. It is frequently useful to cooperate 
wuhnai^r! witli nature in promoting this evacuation. (Chap. XXYII.) (Cf. Coll. 
■ 136, 143 ; Pringle, 200.) 

253. Dysentery. — The usual methods of treating this malady, with 
^xTtT^ which I was acquainted, of ten failed of procuring ease^ and of preventing 
by remov- its ending fatally. It appeared that in a dysentery some hurtful humors 
ufic^mat- had been deposited in the intestines, which threw them into such disor- 
derly agitation as to hinder the expulsion of what had offended them 

Purgatives were administered with the double good effect, both of afford- 
ing present ease, and afterwards of entirely removing, by effectual evac- 
uations, the cause of the disorder. (Chap. XXXL) 

254. Icterus {Jaundice). — Good effects may with reason be expected 
from purging medicines, by their increasing the natural motions of the 
intestines and soliciting a greater flow of bile as well as of all the other 
humors which are poured into them. ' Mercurial purges have been pre- 

_,otherand fei't-ed by some practitioners, but there appears nothing in the hnown 
safe^'purga- power s of mcrcury pcctdiarly usefd in dislodging a biliary concretion, 
and the preference should be given to those purges wich act with the most 
ease, and may be continued with the greatest safety. (Chap. L.) (Cf. 251.) 



tet 



Javmdice. 

Avoid mer- 
cury, but 
use 



Colic. 



cure. 



Evacua- 



255. Ileus {Colic). — The peculiar and distinguishing symptom 
which characterizes the inflammatory colic in the very beginning is cos- 
PwrgatiAiel tivcncss, which it is always extremely difficult, and too often impossible, 
to conquer. As soon as a discharge downwards can be procured in a 
copious manner, the patient perceives a quick abatement of all his mis- 
uons^"'mM%\. ery, and is often restored to health. But it is not from one or two small 
^eda^iT'co- cvacuatious that we can entertain much hope of the distemper beginning 
^stfrTre^o?^' ^^ Z^^^ way. This has happened on the first or second day, from the 
ery. excrement which was lodged in or near the rectum, far below the seat 
of mischief. And later in the distemper, a very small portion of that 
liquid matter with which the bowels are deluged has seemed to have 
been forced downwards, while the disease was every hour growing 
worse. Such inefficacious evacutions have been observed more than 
once or twice in the course of this illness, without saving the patient's 
life "Warm baths, fomentations, &c., are serviceable helps in dis- 
posing the bowels to yield to the power of cathartic medicines, by the fail- 
ure or siiccess of which the life or death of the patient 'must at last be 
determined. (Chap. LI.) (Cf. Hipp. 12, 38, 41, 45, 57. Parep, 85, 87.) 



Apoplexy. 
Evacuation 
of the bow- 



THE DOCTRINE OF PURGATION. 65 

* Ttro. — On Apoplexy. See Med. & Phys. Journ., 1802. Vol. 
YIIL {Controversy between Mr. Crowfoot and Dr. Lang slow on the 
questixm whether emetics or Heeding he applicable in apoplexy f 

256. In addition to tlie testimonies adduced by Pyrrho (one of the 
writers participating in the controversy), I shall only add, that Baglivi^ 
who divided apoplexy into sanguineous and pituitous, observes : 
" Arcanum in sanguineis est phlebotomia. In pituitosis contra emeti- eis by pur- 
Gum^ aut purgans vehimens. Sunt qui apoplexia (pituistosa scilicet) lib- ltmiimg\ 
erati sunt, hausto singulis mensibus vomitivo ex infuso pra3dicto (infus. ^p^elmt'^^ 
croc, metal cum vino)." *. . . .Aretaeus does not recommend emetics, but 
observes : "if the sacred purge should excite vomiting, it is not to be 
restrained, because it evacuates pituita, the cause of the disease, and 

rouses the patient by imparting a degree of vigor." Boerhaave, among 
the general evacuants to be used in this disease, mentions ^vomits and 
strong purges*., though he adds, there is something uncertain in their 
action. Vanswieten^ also, in his Commentaries upon this Aphorism 
(1026), observes, that emetics ought not to be condemned in this dis- 
ease, and are often useful, because they evacuate pituita ; though he 
afterwards ihivikB purgal/ims less ohjectianable, (Journ., pp. 68-69.) 

Bardsley, Samuel Argent, M. D., Physician to the Manchester In- 
firmary^ Dispensary anfid Lunatic Hospital. An Account of the 
Epidemic Catarrhal Fever or Lnfluenza in Manchester^ (&c. See 
Med. AifD Phys. Journ., 1803, Yol, LX. 

257. Emetics were found highly beneficial on the first attack ; in- 
deed, the frequent occurrence of spontaneous nausea and sickness pointed innuenm. 
out their use. They scarcely ever failed to relieve the urgent symptoms f^"'sZm^aSi 
of pain in the head and stricture of the breast. To obviate costiveness, «^^^ ^^'^/^^^« 
and at the same time to cleanse the primse vise, moderate doses of calo- symptoms; 
mel, with rhubarb and antimonial powders combined, were exhibited with cfeallT^"'' 
excellent efi'ects. . . Opiates were seldom employed during the first stage *^®°^- 
of the disorder, as they had a tendency to exasperate the complaints of 

the head and chest, and increase restlessness and feverish heat (Journ., 
pp.525, 526). 

KmGLAKE, Robert, M. D., On Lnfluenza. See Med. and Phys. Journ., 
1803, Yol. LX. 

258. My experience authorizes me to say that the benefit of abstract- 
ing heat, by atmospheric exposure, light bed-clothes, copious dilution 

with cold water, and avoiding stimulants of every description, will purgSes 
almost certainly rescue the patient from danger, and leave nothing more ^^Ji^ine re- 
for medicine to do than gently to move the bowels in case of costiveness, quired, 
and, at most, to aid the refrigerant plan by the milder sudorifics (Journ., 
p. 520). 



a In the sanguineous, phlebotomy is the arcanum. In the pituitous, on the contrary, 
emetics or strong purgatives. Some people remain free from apoplexy by taking every month 
a draught of aforesaid vomitive infusions. (Inf. croc, metal, c. vino.) 



66 THE DOCTRINE OF PURGATION. 

259. It is an erroneous notion that occasional refrigeration and ab- 
eraui^phfn stinence in disease weaken more than a heating and stimulating treat- 
contended nient. The native energy of healthy power is certainly reduced both 
by the abstraction and increase of excitement, but by its due diminution 
vital force maybe said to be nursed, while undue stimulant agency tends 
to dissipate it even to extinction ; hence a moderate negation of. excite- 
ment debilitates much less directly than its excessive employ does indi- 
rectly (Journ., pp. 519, 520 ; Remark). 

Our method for the cure of Influenza is to purge very freely withBrandreth's Pills, six 
pills every twelve hours the first day. Keeping' in bed as much as possible ; oatmeal gruel 
or light broth ; if the head is very painful, feet in hot water with mustard or wood ashes; 
if throat is sore, gargle with weak alum-water ; outward applications are the Allcock Plas- 
ter, mustard poultice, red pepper, or any stimulating liniment. When the skin of the 
throat becomes a little red, the outward applications dispensed with. Should a choking 
sensation be felt, or the breathing be difficult, four Brandreth's Pills must be taken every 
four hours, or even oftener, until relief is experienced. 

O'Beene, p., Surg., Observations on the Fevers in Hot Climates. Lon- 
don^ 1803. Bee Med. and Phys. Journ., 1803, Vol. X. 

Yellow f 6' 

ver. 260. The more severe in symptoms, and dangerous in effect, any dis- 

ease is, the more necessary the investigation of, and researches after, 
methods of cure must be fully impressive on every mind ; it is scarcely 
necessary to add that perhaps none comes more strongly under this de- 
scription than that generally termed yellow fever j none, therefore, more 
Its com- interesting claims our attention. 
T^m^uma^' In the commencement, generally nausea, pain in the head, loins and 
and general hams, succecd ; dry surface, increased pulse, but not to be depended on, 
course. varying from 80 to 140, chills, anxiety, sighing, prostration of strength ; 
vomiting soon takes place, and not unfrequently is the first indication of 
the disease. The vessels of the tunica conjunctiva become turgid, and 
a yellow tinge of that membrane takes place, frequently extending over 
the body. Notwithstanding this circumstance gives rise to the name 
usually given this complaint, it is by no means a constant attendant, and 
in many totally wanting. Watchfulness and desire to sleep, without 
being able to effect it ; whilst in others constant dozing, pain and sensa- 
tion of heat in the stomach, great thirst ; vomited matter gradually 
changes from yellow to dark green, and at length perfect black. Clammy 
skin, sometimes petechise, but unfrequent ; stupor or violent delirium 
succeed ; paroxysms of vomiting become more rapid, and many expire in 
one of those paroxysms too shocking to describe, whilst others placidly 
resign exhausted nature (Journ., pp. 36, 37). 

261. No disease perhaps exhibits a greater variety of symptoms, and 
and sudden oftcn Icss to be depended on, than this ; sometimes it goes on with every 
cJumges. favorable appearance, suddenly changes to the worst, and patients, ap- 
parently almost in a state of convalescence, expire in an hour or two. 
This is a melancholy fact (Journ., p. 37). 

262. The symptoms that we may call favorable are, settled state of 
the stomach, lessened headache, eyes lively, formation of pustules over 

The/<M)or- the surfacc, or that eruption known in tropical climes by the name of 
toms. ^"^ prickly heat, I have ever remarked as almost a certain indication of re- 
covery ; bilious flux, copious and high-colored urine, free perspiration, 
and sound sleep (ibid.) 



The dan- 
gerous 



THE DOCTRINE OF PURGATION. 67 

263. The dangerous, and, I am sorry to add, most common, symp- 
toms, are severe headache, frequent vomiting, heat increasing to a burn- 
ing sensation, extending down the trachea and alimentary canal ; matter ^y^ptoms, 
vomited and faeces becoming dark, frequent sighing, dull or glassy eye, 

pale and little urine, dark fur on the tongue, muscular and nervous de- 
bility, intermittent pulse, clammy feet, cold sweats, stupor or violent 
delirium, singultus, coma (ibid.) 

264. That dark matter vomited, termed hlach vomit, it may be neces- 
sary to remark, although laid down by most authorities as a certain fatal 

sign, is by no means so, as I have seen many recover aiter it; it is also The iiaeh 
said "that a diarrhoea almost precludes any hopes of recovery." If hy ^diarrh^a 
diarrhoea is understood a simple {or hilious) flux, I have ever observed it faua\y^l. 
a decided fortunate event \ certainly a flux oi putrid darh fceces is ex- toms. 
tremelyhad, am.d yet even thatl have many times ^qqb. 2>T0ve salutary 
(ibid.) 



The TREAT- 



AT ALL 
EVENTS ; 

emetics ad- 
missible with 



265. Our first and principal attention should be directed to clearing 
the first passages, and to heep them free during the disease being of the 
greatest importance. ment 

Emetics are by many laid entirely aside, on the principle of increas- 
ing the already irritable state of the stomach. That a great deal of i^ t^e ^ 
caution and discrimination in their use is extremely necessary must be purgation 
allowed; but I am decidedly of opinion much benefit is to be obtained 
by them. Where nausea or slight vomiting occurs, ipecacuanha is the 
best; but if the vomiting, be more severe, an infusion of chamomile will caution, 
answer every intention. 

Cathartics. — Calomel, combined with powder of jalap, is perhaps one 
of the best ; the irritating quality of the neutral salts seldom makes 
them advisable. 

266, Blood-letting has been advised by some of the most respectable Bleeding 
authorities ; I shall therefore only observe that I never saw it used with afJays^hurt- 
adA)antage I on the G0Yiiv2LYj, I always thought it of disservice {Souytl., ^"^^^ 

p. 38). _ • 

m 

26Y. Our next intentions must be directed towards lessening the inthe.^6c- 
irritable state of the stomach, supporting the strength, and resisting that one/ ntage, 
tendency to putrescency that exists in this disorder. pSar^^^ 

Notwithstanding the- great variety of opinions that have been, and the'^^^l^S* 
still are, on this subject, calomel ^v^ill still perhaps be found the most musthekept 
successful medicine hitherto employed, and, in general, I have but little "^ "' ' 
doubt its want of success in many instances may be attributed to the 
manner of giving it, or want of atten'ion to the state of the bowels. Cal- 
omel if not given in large quantities quickly repeated had better not be 
given at all. I have used from five to eight grains every two hours, and 
sometimes every hour, combined with three grains of the antimonial 
powder, until a diaphoresis was induced, when the latter was omitted, 
and the calomel continued until the effect was evident, as metallic taste, 
foetid breath, or sore mouth. When a gentle salivation is raised, desist 



constantly 
/fee. 



68 



THE DOCTRINE OF PURGATION. 



Sxtenial 
remedies. 



Enemas. 



Opium 
and tarh 
useless. 



in frequency, yet continne so as to keep up the effect of the mercury ; 
the criterion of its success may be determined by its action or non-action. 
When a speedy and copious salivation comes on, tlie most happy effects 
may be looked for ; while the contrary prove the reverse. And here 
ao-^in let me observe that the most minute attention m.ust he paid to Tceep 
tKe howels free., for which purpose enemas are the best (Journ., pp. 
38, 39). 

268. Blisters, although uncertain, are of great utility both in pre- 
venting delirium and lessening vomiting, applied to the region of the 
stomach. General warm hath is of the utmost service, or, where that 
cannot be conveniently had, washing all over with warm water (Journ., 
p. 39). 

269. Of all remedies in use for this disease, excepting calomel, per- 
haps none are of more real service than enemas, and the more simple the 
better — such as warm water, oil and vinegar ; but on the increased vas- 
cular action and heat subsiding, enemas composed of orchis, sago, or 
portable broth ; this last I have found of such uncommon service as 
makes me wish most strongly to impress the use of it ; in many cases, 
where animation seemed nearly exhausted, recovery was the unexpected 
and welcome effect of this salutary practice (ibid.) 

270. Opium I have found of little, if any, service, in any stage. 
Cinchona appears to me evidently of disservice until the patient is 

in a convalescent state (ibid.) 

Brandrefh's Pills are in every respect superior to calomel as a purge, and they leave no 
evil after effects. 



PoTTEE, Nathahiel, M. D. Letter on the Epidemic Distempers of the 
year 1802. Baltimore, 1803. See Med. and Phys. Jouen., 1804, 
vol. XI. 

271. The cure of measles this year may be almost reduced to two 

Measles, simple remedies, hlood-letting and purging. For, when these were used 

Purging \^ time, and carried to a sufficient extent, little or nothing remained to 

ployed c«res be douc. Thcsc rcmedics were no less efficacious in removing the im- 

vmts^hliA mediate symptoms than in removing the ^onsequences of the disease. 

^' This will be sufficiently apparent when we enumerate the deplorable 

train of consequences that followed their neglect (Journ., Y, 312). 



conse- 
quences. 



Purgatives 
cure by car- 
rying off 
the morbid 
rnatt&r. 



272. Purging was a very useful remedy, and required to be repeated 
every second day, or oftener, as there was a constant reaccwnulation of 
that green and acrid matter that was sometimes ejected from the stom- 
ach on the first attack ; and this disposition commonly lasted four or 
^YQ days. Where purging was neglected in the commencement, the 
evacuations from the intestines were often of a darh green, hroimi or 
hlack complexion, just as it happens in other malignant fevers (Jom-n., 
p. 313V 

273. Antimonials were certainly improper remedies in this disease ; 
they depressed the pulse, and seemed to act too much like the causes of 
the disease. Are not antimonials equally unfit remedies in all malignant 



THE DOCTRINE OF PURGATION. 69 

fevers, where the tendency to indirect debility is great, and more espe- 
cially in those called contagions, where the " vis nocens " is so prone to niat^^^t^ 
induce the same state of the system ? gether inju- 

'^ ' rious ; hlis- 

ters and opi- 

Blisters were equally inapplicable in the first state of the disease, uTmafclX. 
but co-operate powerfully with emetics in arresting the progress of indi- ^^^^^^^^'^^ 
rect debility in the advanced state of measles, and sometimes called 
forth dormant excitement to great advantage. 

Opium was also inadmissible in all its forms, unless toward the latter 
state, when fever did not contraindicate its prescription for the cough, 
which was often the last troublesome symptom, and seeminglv occa- 
sioned by the action of a small portion of the pulmonary vessels (Journ. 
p. 314.) 

Power, Geoege, Surg.^ Assistant Surgeon to the Tweniy-tliiTd Regiment 
of Foot, Royal Welsh Fusileers. Attempt to investigate the cause of 
the Egyptian Ophthalmia, <&g. See Med. and Phys. Joukn., 1803, 
vol. tX, 

274. The next local cause of Ophthalmia in Egypt is the custom of 
sleeping at night in the open air, imbibing with every inspiration, and ophthai- 
absorbing at every pore, the putrid virus contained in the descending '^^^^^^^^^ ^^ 
dews. . . . Thus in a system peculiarly debilitated, and unable to resist ntght-dew 
all its powers combined, it produces that highly putrid fever called mauf p^?o- 
plague. In a patient less relaxed, as the habit of the body determines enf dfseSs 
the disease either to the surface of the skin or to the intestines, an erup- according to 
tive fever or dysentery is produced ; and when the putrid virus is but tio^n.^ ^^^°^^" 
partially applied, to the eyes for instance, or to the month, or even on 

the surface of the body, ophthalmia, ulcerated fauces, or ichorous hlotches 
on the skin ensue (Journ., p. 78). 

275. As the author freqently refers to a treatise of the French Sur- 
geon Bruant, it will be of interest to know what this writer says on the 

cure : " This disease is frequently cured by the simple operation of na- Naturein^ 
ture, and without any assistance from art ; and indeed we may affirm dicate^i the 
with truth that nothtng so much opposes the cure as too great a profusion evaJuaUon. 
of remedies, especially topical. Some patients have been relieved by an 
eruption coming on at the temples ; others, and the greater number, by 
a slight diarrhoea ; and hence, to act conformably to the views of nature, 
I have encouraged a discharge from the bowels during the whole dura- 
tion of the disease, by employing tamarinds or other laxative titans 
(Desgenettes Histoire Medicale de I'armee de TOrient. — Journ. p. 580). 

Wadlet, T. W., Surg., on the Prevailing Epidemic Influenza. Stow on 
the Wold 1803. See Med. and Phts. Jouen., 1803, vol. IX. 

276. First, the exhibition of an emetic was always promised, which 
seldom failed of evacuating the stomach of a darh colored, greenish, and 
most offensive fluid. Aperients were always rejected when given before 



70 THE DOCTRINE OF PURGATION. 

{rom^bi/io^^ ail emetic, and an enema was fonnd of no service. The pain in the 

ncciimuia- head was constantly lessened and frequently removed by the vomit, and 

IhirkioS!^^ ^ freer expectoration sometimes relieved the congh. When costiveness 

maiZ'^'^' ^^'*^^ ^ ^'^^T urgent symptom an active picrgative was given, which never 

cu>y by failed of Ibeing folloived hy stools of a peculiar fmtor and hlach color ^ 

theSuse/ and tliis state of the alvine discharge often accompanied the disease 
throughout (Journ. p. 516). 

Medicus, Practical Observations on the Treatment of the Scarlet Fever 
and Sore Throat See Med. and Phts. Jouen., 1804, vol. XII. 

2TT. It is well known that many pass very safely through the scarlet 
ve^^y^hen fcver^ in its mild state, with little or no medical assistance. But when 
qi^res' Tut ^^^ ^^^^^ statc mcdiciucs are administered, I fear the cure is, by the inge- 
littie medical nious theoTctical practitioner, ascribed too often to their effects and not 
to the mildness of the disease, especially if some fashionable medicine 
has been prescribed. Hence remedies undeservedly creep into prac- 
tice, and, I fear, in serioas cases frequently supersede the use of those 
which have long stood the test of sound practical experience. 
The cause I pretend not to -account for the source or origin of the scarlet fever 
~iZitur\n ^^^ sore throat, but am well satisfied that the " fomes morbi " of the 
mnii"T^^~ ^is^^se, however generated, lurh in the howels. Under this con^dction 
moved^by^ I cujoin them to oe well cleared., in whatever stage or however violent the 
purgatwes. g^g^Q^g^ jy^gjy j^^ ^rheu I first scc the patient, if I suspect that such necessary 
treatment has not been before observed. The very foetid smell of the 
evacuation, and the relief such evacuation immediately procures^ strongly . 
prove to m.e the necessity of purgatives^ and I may add, from reiterated 
observations, that the longer they are delayed the more severe proves 
Briskpur- the discase. Many practitioners, alarmed at apparent debility, are de- 

Q OttOTh OOPS tJ X, / J. X t/ / 

not hurt, but teiTcd from exhibiting brisk cathartics lest their operation should irre- 
*^the vUar coverably sink the patient. Such apprehensions would be justly 
power. founded if purgatives were administered without due discriminating 

attention to age, constitution, and immediate state of the patient. But 
where such attention is paid, I have never seen any mischief arise ; on 
the contrary, the most salutary effects have taken place merely from 
the howels being relieved from the contained accumulated foetid fceces, 
and hence every febrile symptom becomes milder., and the vital powers 
inwigorated., not debilitated (Journ., pp. 26, 26). 

Patteeson, W., M. D., Case of Brainular Affection from an Internal 
Cause. Londonderry, 1804. See Med. aotd Phys. Jouen., 1804, 
Vol XII. 

2Y8. A gentleman, aged above sixty years, was suddenly attacked 

Apopieoyy. with a sevcre pain in his forehead, accompanied with so much megrim 

^lllpda- ^^*^ stomach sickness as would have caused him to fall had he not re- 

touncharao ccivcd support ; to these symptoms was added coldness. He was put to 

bed ; blood-letting pretty ' largely in the arm ; purging, and blistering 

the back, legs and head, in succession, were employed. Four days after 

the seizure, when I was called, I found him in bed complaining grievously 



THE DOCTRINE OF PURGATION. 71 

of a violent pain in the forehead, together with an irksome stricture in the 
eyeballs and surrounding teguments. The functions of the brain were purgation 
impaired by a degree of stupor, attended frequently with incoherent '^/^^i^^^.^f® 
mutterings. His pulse was unequal, laboring, and accelerated with a the head Hm 
tenseness in the vessel ; the temporal arteries throbbed considerably, but tlTeqimh- 
were uniform in their action. The countenance was sometimes pale, ci^cuSuon 
sometimes reddish, and at other times suffused with a bluish tinge ; the 
eyes were languid, and the sense of vision much diminished, at periods 
almost lost. The temperature of the skin was sometimes pretty high, 
more frequently below the medium warmth, and generally felt languid 
and flaccid. There was sometimes an urgent thirst, but for solids little 
or no appetite. His stomach, indeed, continued to have a loathing, and 
so retrograde a disposition as to approach vomiting, which he himself 
considered to proceed from vitiated bile. His bowels were sluggish, and 
had not emptied themselves since the operation of the laxative medicine, 
which was a space of thirty-six hours before I saw him. He was rest- 
less, and when he seemed to sleep it was a morbid comatose state rather 
than a salutary repose. The organs of respiration did not appear par- 
ticularly engaged, and the urinary organs were equally unaffected. 

From the preceding phenomena I concluded that there existed a de- 
termination of blood to the head, with increased tension of the arteries 
of the part. Under this impression, I ordered local evacuations, by 
means of numerous leeches to the temples, and a hrisk cathartic to excite 
and empty the bowels, as well as to promote an equilibrium in the gen- 
eral circulation. The first application of leeches procured a sensible 
relief, and therefore it was repeated. The cathartic was not active enough 
in its operation, and accordingly a stronger one, composed of calomel and 
aloes, was given, and with manifest advantage. The stupor in a short 
time decreased, and was succeeded by a loud talkative raving, accom- 
panied with unconsciousness of persons and things around him, of which 
inattentive state a remnant continued for several days. The delirious 
condition lasted for some hours, and was followed by a profound sleep, 
attended with a stertor resembling that of apoplexy, but distinguishable 
from it by softness and equable movement in the pulse. This change 
was the harbinger of convalescence, which gradually but slowly took 
place. 

Considering the phenomena of this case, I am led to conceive that 
we would be justifiable in setting it down as a decided instance of apo- 
plexy ; but certainly it was rather of an anomalous description, as it 
assumed many of the features of a species of erysipelas which takes 
place in the membranes and vessels of the brain in the evening of life 
(Journ., pp. 109-111). 



Pearson, A., Surg., in the service of the East India Company. Some 
Observations on the Pathology and Prevailing Diseases of Warm 
Climates. London. 1804. See Med. and Phys. Jotjkn., 1804, Vol. 
XL 

279. On Acclimation. — In the first change from a cold to a hot cli- 
mate it was formerly the practice to bleed indiscriminately ; it is now per 



72 THE DOCTRINE OE PURGATION. 

liaps too generally omitted, as it might be often employed to obviate or 
is^('[/S'ami veinove disease arising from inflammatory congestion. Pi^/'^m^ lias also 
b)7^prereu- ^^^^'^^ rceommended fov unimrsal adoption • and when we reflect that the 
tire of cji- coustitutloii l)oth admits and requires this evacuation more frequently in 
eases!' *" wami than in cold climates, and hears it better, its ntility will be found 
• as probable as experience proves it to be. The neutral salts have been 
generally prescribed, and these are certainly of the most universal appli- 
cation and use ; but vegetable purgatives will be best for frequent use. 
(Inf. sennse et temarind, p. rhei. et kali tartar, separately or combined ; 
of the former 3j. to 5 i-, and J j.to § ii. of the latter.) Occasionally four 
or five grains of calomel may be taken with much advantage, from its 
eflect in stimulating the mucous or biliary excretories, when some of the 
laxatives above specified ought to be given next morning. The day on 
which any of these remedies are given ought to be one of peculiar mod- 
eration, and dilution with barley-water or rice gruel attended to. 

With regard to the use of tonics, or antiseptics, the indications for 
Deuuty employing them, and their utility, are much less than is generally sup- 
Sity^o^S" posed. The feeling of debility is often fallacious, and produced hy the 
cretion. organs being overloaded^ or a biliary absorption (Journ., pp. 161, 162). 

280. In the warm climates the attacks oi febrile disease are gener- 
FeDers ^J accompauicd with symptoms of bilious absorption^ and torpor of the 

The symp- intestinal canal, and with a greater or less tendency to remission. The 
cSi pwga- treatment recommended by authors is very contradictory ; some advising 
gi^ii^g""^^' a continued and severe evacuant plan, while others administer bark on 
every appearance of remission, and even without waiting for it. If 
purging with calomel and neutral salts is assiduously practiced in the 
first days, giving intermediately mild diaphoretic and antimonial medi- 
cine, the use of bark will be found unnecessary (Journ., p. 201). 

281. I am doubtful if the genuine remittent fever appears without a 
Miasmata previous cxposurc to the exhalation of marshes, or that from rank vege- 

the cause tatiou I aud the distinct remissions and exacerbations described in books 

act upon the are not irequently to be met with. . . It is frequently some time ajter 

^prTsling ih.1 the application of the remote causes before the disease coTnes on. . . The 

^mutcuiaf' debilitating effect of the marsh-miasmata is generally recognized, and it 

actvoipy, IS probable that the nervous energy and muscular irritability are much 

and suddenly impaired by their impression upon the sensorium ; the 

powers of circulatiDg the mass of blood are for a time diminished ; from 

that, irregular actions of the vessels of different viscera, a relative degree 

of plethora and inflammation takes place, while, from the excretories 

being similarly affected, the power which the economy possesses to rid 

itself of an excess of heat is abated. In such a state it is not surprising 

that congestions should take place in the brain and glandular viscera 

(Journ., pp. 201, 202). 

BEiiTNioN, Thomas, Su/rg., on the Gibraltar Fever. Gibraltar, 1805. See 
Med. and Phys. Jouen., 1805, vol. XIY. 

rauar?f?ver ^^^' ^^ ^hc first the patient is seized, without any previous notice, 
fevTlrtak- ^'^^^ giddiness, pain of the head, slight sickness at stomach, darting 
inl^Sfthe pains from the head to the back, and spasmodic affections of the calves 
pS?%e? of the legs. The breathing was very hot, incessant sighing, the greatest 
Kui^'^^°'^ dejection of spirits. The tongue was in the beginning white ; a bad 



THE DOCTRINE OF PURGATION. 



73 



taste was complained of; the sense of smelling was iiriperfect or de- 

? raved ; the visage extremely distressed, and unwillingness to speak, 
'he countenance on the first attack became suddenly sallow ; in a very 
short time, however, it became red, fulland bloated, with the exact ap- 
pearances of intoxication. Drowsiness and sleep followed in a few hours, 
when a little moisture came out on the skin. This appearance, however, ^ 
at this stage was delusive ; it suddenly left the patient, and was succeeded 
by the most intense heat, that gave a smarting sensation to the fingers 
when applied to the skin. There was at this time a most uncommon and 
offensive smell from the whole body. The eyes were now much inflamed; 
there was violent pain in the temples and over the arches of the eye- 
brows, darting to the orbits. The pulse from first to last was greg^tly 
increased, but never so strong and firm as in inflammatory diseases ; the 
thh'st less than generally in acute diseases. There was strong pulsation 
in the carotid arteries, and an evident enlargement of the jugiilar vein. 
The color of the skin approximated that of the lilac, cocklicoque, violet 
or poppy, and changed as the disease advanced to a deep yellow. By 
the early administration of strong emetics and jpurgatives on the first 
attach, the yellowness seldom appeared, and every other had sym^ptom was 
averted (Journ., pp. 137-138). 

283. When these had not been exhibited, and in cases where the dis- 
ease from first appeared in a more aggravated form, the second set of 
symptoms soon appeared ; the patient was very comatose, much tremor 
of the limbs, frequently an incessant vomiting of black matter, with 
convulsive hiccough ; the eyes were drawn in a direction alternately from 
the nose to the temples in a frightful manner, with nearly total blind- 
ness. The skin was now parched with burning heat, or covered with a 
clammy offensive sweat. The body was covered with petechise and 
vibices, swellings appeared in the armpits and groins, often degenerating 
into abscesses ; foul gangrenous sores on the back, and carbuncles on 
different parts of the body. There were hemorrhages from the nose, 
ears, mouth, and pores of the body, with every appearance of a total 
dissolution of the blood-vessels. Then the fgeces and urine were passed 
involuntarily, and the other usual symptoms indicated speedy dissolu- 
tion (Journ., p. 138). 

284. My first step was invariably to put the patient into a warm 
bath, then to rub the body well with soaped flannel, and put him to bed. 
If the powers of life were strong a solution of tartar emetic and glauber 
salts was given, which generally operated smartly both on stomach and 
bowels, so that I frequently had little more to do but remove the debil- 
ity, the patients being often well on the third day. If the solution, per- 
severed in, did not operate, the stomach and bowels being very insensible, 
I gave calomel either alone or combined with jalap and the compound 
extract of colocynth, I endeavored by all means to keep up the alvine 
discharge ; when obtained, the patient was' perfectly relieved and free 
from fever ; if not, the fourth or fifth day put an end to all enquiry. 

After procuring evacuation, I prescribed saline medicines, when 
little fever remained ; but when the disease continued after the third 
day, it turned out to be the severest typhus. Opiii^n or harh did not 
succeed ; when liberally given, I perceived them evidently doing mischief 
(Journ., p. 139). 



Symptoms 
of the first 
stage avert- 
ed by emet- 
ics and 
strong 
purges. 



The symp- 
tom,8 of the 
second stagA 

and the 
close. 



The treat- 
ment hy full 
e'vacuation 
of stom,aeh 
and howels. 



r4: THE DOCTRINE OF PURGATION. 

Clark, Thomas, Snrg., Observations on the Nature and Cure of Fevers 
and .Diseases of the West and East Indies^ and of America^ c&c. 
Edinburgh, 1805. See Med. and Phys. Jouen., 1806, Vol. XY. 

dtsentert. 285. Dysentery. — Having, in violent cases, often found the remedies 

i-mJtic"'sib- ^^^ described, or any others that I had tried, ineffectual, I at last had 
*''"\i?o in recourse to the use of emetic substances in the way of injections. I did 
pifes''„ndin- not adopt thcse, however, till I had reflected very seriously and reasoned 
■S"the"'rec- verv fully on the subject. The other remedies already mentioned, except 
turn, &c. injections, were administered at the same time. From much experience 
I do not hesitate to assert that they have been, and, I believe I may 
venture to say, will be, found extremely beneficial in dysentery. It ap- 
pears to me more than probable that they will also prove useful in cases 
of piles, and, in short, in all kinds of inflammation affecting the rectum 
arid parts adjoining. When given early in the disease they generally 
afford immediate relief, and sometimes one or two injections effect a cure. 
When they have not been used until the advanced stages the patients 
experience more uneasiness from them, particularly on their first being 
thrown up ; but if they can be prevailed upon to keep them for a min- 
ute or two, the uneasiness in a great measure ceases, and they are often 
able to retain them for a considerable length of time. The manner in 
which these injections operate is for the most part as follows : 

In the incipient stages of the disease, even when attended with vio- 
lent pain and tenesmus, and all the more violent symptoms of this dis- 
ease, immediate relief is almost constantly experienced from them ; and 
nJ^how^l' ^^1 ^^^ commonly retained for a considerable length of time with little 
operate. or uo uneasiucss. At length an effort to go to stool comes on, and several 
copious natural evacuations, mixed with mucous, are procured ; and in 
the more violent cases several evacuations of slime, or mucous alone^ or 
intermixed with hlood, succeed to the natural stools, accompanied with 
little or no straining. After this, the patient commonly remains for a 
number of hours without any symptoms of disease, and in some in- 
stances it does not return. 

Those injections do not appear to occasion vomiting, or even to in- 
crease the irritability of stomach that may have previously existed. 
^mL the' They probably assist in increasing perspiration, however. I do not 
secretion of belicvc that thcv Operate very powerfully in that way : at least, in some 

mucous and ^ ^ "^ ,^ . . *^ •! i i • .' . -, 

carry it off cascs, 1 havc louud it impossiblc to produce a copious perspiration by 
mthouTpo- ipecacuanha, both in the form of injection, and also at the same time 
Si^InT^ given by the mouth, in considerable quantities. 

movl the in- Xhe solutaru effects of these iniections appear to me to depend chiefly 
from the in- upou thcir cxcitiug a COPIOUS secretion oj mucous irom the internal coat 
nai^knd rec- of the great guts, and thereby removing the inflammation affecting 
turn. them. 

I have known a few ounces of this injection give immediate and 
permanent relief in several instances of very painful inflammatory affec- 
tions about the extremity of the rectum ; a copious secretion of mucous, 
resembling the white of eggs, being produced. 

I generally have given two, and sometimes three, in the course of 
Their ap- tweuty-fouT hours. The best general rule, I believe, is to administer 
pUcation. injectious whenever the more violent symptoms of dysentery return, or 
tlireaten to do so. 



THE DOCTRINE OF PURGx\TION. 75 

Strangury^ which frequently accompanies violent cases of dysentery, 
will be found very seldom troublesome when these injections are used ; xf^2vS^% 
the reason why it is not so must appear obvious to every one. |f'^ '"j«<^- 

The form of injection which I have found to answer best has been 
about three drachms of ipecacuanha root, bruised, and boiled down in a i\i&pre- 
quart of water to one pint, and given at once as a clyster. From ten to (he'enema"^ 
twenty grains o^ tartar emetic, dissolved in a pint of warm water, will 
produce nearly similar effects (Journ., pp. 85-8 Y). 

Dys^entery and Diarrhea. — These affections of the bowels are Nature's efforts to expel 
diseased matters from the blood, and must never be suppressed ; but nature must be assisted 
by a free use of Erandreth's Pills, which are absolutely certain to cui*e if used before the 
powers of life are exhausted. 

Dr. Clai'k's method is vastly superior to opium or any of the astringent remedies so 
readily prescribed by the generality of medical men. But Brandreth's Pills are certain and 
commit no mistakes. If convenient, an ejection of pure water, about summer heat, will be 
found to comfort the bowels, but the cure depends upon purging the humors from the blood. 

Hamiltois^, James, M. D., Physician to the Boyal Infirmary and various 
Hospitals in Edinburgh. Observations on the Utility and Admin- 
istration of Purgative Medicines in Various Diseases. Edinburgh. 
1805, %th edit, 1833. 

2^6. The history of medicine clearly shows that theory or reasoning- 
has contributed in no small degree to impede its progress. v.^ltll'^ 

Let it be our endeavor, by circumspect induction Irom facts, to estab- {^"f^ ;*."■ 
lish sound principles which may lead to the discovery of other facts, and medicine!' 
these again to the introduction of more general doctrines, or a compre 
hensive and connected theory of medicine (p. 21). 

2-^7. The nutritious part of our food is prepared and separated by The mode 
the changes which it undergoes in the mouth, oesophagus, stomach, and, of '/^'f^e.^.'fw?. 
with the assistance of fluids secreted from the liver, pancreas, and spleen, of the stom- 
is perfected in the smaller intestines ; while the lacteal vessels, opening 
on their internal surface, absorb and convey the nutrimental fluid into 
the circulating system. The residue of the food, which is not adapted 
to aflbrd nourishment, constitutes part of the fecal evacuation which is - 
made directly from the intestinal canal (p. 21). 

288. This fecal residue is discharged into the more capacious colon, ^^ ^^^^^ 
where the ilium enters it by a lateral opening, so contrived that the 
contents of the colon cannot be returned. This circumstance makes a 
distinction between the functions of the smaller and larger intestines. The big and 
which is not commonly noticed. The former complete the preparation ^^^}l ^ntes- 
of the nourishment, and afford opportunity of its being absorbed; while 
the latter receive and detain the fecal part till after it has accumulated, 
and, perhaps, undergone certain changes, when it is voided in a given 
quantity and at stated intervals (p. 22). 



uch and in- 



fixes. 



289. Besides, the intestines exhale and throw of fluids which have ^ ^^^ 
become noxious in consequence of changes which they undergo in the function of 

Z^-/.. rm. - •__j___^'„_i 1 ^^-. 4.*.^^ r. — .^ — ^1^^ ^l^„l.l^ ^J? the intes- 



body. The intestinal canal, therefore, serves the double purpose of 
repairing waste and of preventing decay. In this latter function, which 
I am solely to consider, the intestines co-operate with the other secretory 



tines. 



76 



THE DOCTRINE OF PURGATION. 



/unction of 
organs. 



Pretention 
of fecal 
matter 
causes dis- 
ease ; regu- 
lar diges- 
tion neces- 
sary for 
health. 



organs, the skin, the hmgs and kidney. All these organs have, in re- 
spect of this their common relation to the system, a dependence upon one 
another, and any of them will compensate, to a certain extent and for a 
limited time, the interrnpted action of the others. Nevertheless, their full 
activity is necessary to the enjoyment of perfect health, and the contin- 
uance of life ; and the regularity of the intestinal evacuation is connected 
in a particular manner with the well-being and healthy state of the 
stomach and intestines themselves. The urine and perspirable matter 
pass oif immediately after being secreted, and do not load the organs 
which separate them. The unnatural detention of these excretions has 
indeed a more of less remote, and often fatal, effect upon the general 
system, but the skin and the kidney remain uninjured. It is otherwise 
with the intestines : secluded from that communication with the atmos- 
phere by which the perspirable matter is carried off, and unprovided 
with an appendage resembling the urinary bladder connected with the 
kidneys, they are the reservoirs of fecal matter as it is poured out, which 
they retain till the accustomed period of evacuation comes round. Dif- 
ferent circumstances are apt to induce irregularity in this evacuation ; 
these, together with the facility with which the larger intestines admit 
of distension without uneasiness being excited, give frequent oppor- 
tunity for a progressive accumulation of faeces, whence arise interrupted 
action of the stomach and smaller intestines, and consequent dangerous 
and fatal ailments (p. 22). 



Evacua- 
tions. — 
Their ap- 
pearance 
indicati've 

of either 
health or de- 
rangement of 
the bowels. 



290. In infancy, the alvine evacuation is frequent, and the faeces are 
abundant and fluid. In mature years the body is generally moved once 
in twenty-four hours, and the faeces, although soft, preserve a form too 
well known to require description ; they are of a yellow color, and they 
emit a peculiar odor. When, therefore, the faeces are evacuated less 
frequently than the age of a person demands ; when tliey are indurated ; 
when they change their natural color and odor, derangement of the 
stomach and bowels is indicated, and the approach of disease, if dis- 
ease be not already formed, is to be apprehended. For it is not to be 
imagined that organs of so great importance in the animal economy as 
the stomach and bowelsare, can belong in a state of inaction, and the 
general health remain unimpaired (p. 23). 



Peristal- 
tic motion 
of the bow- 
els, if inter- 
rupted by 
conatipa- 
tion. CHUses 
excrementi- 
tious (iccu- 
mulatiorifi 
producing 
dAsea se. 
Its cure by 
purgation. 



291. ThQ propulsion of the contents of the intestines is effected by 
means of a vermicular, or, as it has been called, a peristaltic motion of 
the bowels from above downwards ; hence torpor, or loss of tone in the 
muscular coat of the intestines, by which this motion is thought to be 
interrupted, is understood to be the cause of much distress, and tonic or 
stimulant medicines are employed to remedy this torpid state. I use 
this language, and speak of torpor of the bowels, although my ideas 
respecting it do not correspond with those of others. I am inclined to 
think that the symptoms referred to loss of tone proceed, in many 
occasions, more directly from the impeded peristaltic motion, the conse- 
quence of constipation. In this situation we may easily understand 
that the distended colon cannot, for want of space, receive the contents 
of the smaller intestines, which will of course stagnate throughout the 
whole canal ; the action of which being thus interrupted, will soon alto- 



g 



ether cease, and be at last inverted. The various ailments which 



THE DOCTRINE OF PURGATION. 77 

thence ensue, are daily before our eyes ; and tlie relief which, under 
these circumstances, we observe to follow soon after the exhibition of a 
purgative, and the cessation of complaint which takes place upon its 
operating freelv by stool, are in proof that this opinion is well founded. 
If^ again, loejarther consider that the greater part of the exhalations 
made into the cavity of the intestines is exerementitious, and will, if re- 
tained heyond the usual period, undergo changes and acquire injurious 
acrimony : and if, moreover, we advert to the sympathy which many of 
the organs of the complicated animal frame have with the stomach and 
intestines, we cannot but recognize the great influence which these must 
possess over the comfort, the health, and the life of the individual 
(p. 24). 

292. These are weighty considerations, and ought to excite our 
attention to any irregularity of the alvine evacuation. The necessity of 
this will farther appear when we reflect that many circumstances, unavoid- 
able in social life, expose mankind in a peculiar manner to constipation ; ccmsUpa- 
such as improper food, intemperance, sedentary occupations in confined ^lu^"^*^ 
or otherwise tainted air. Besides, in a therapeutic view, we are encour- 
aged to exercise this attention. It is admitted that diaphoretic and constant 
diuretic medicines employed to remedy interrupted secretion by the Sf^^^stSe of 
skin and kidney, operate circuitously, often possess deleterious qualities, ^^^f^ l^ecom- 
or are uncertain and irregular in their eflfects ; while the means of re- mendabie. 
moving constipation act directly on the seat of disease, are safe, and 
seldom disappoint us in the attainment of our object (p. 25). 

293. In the dawn of physic, purgatives were employed. But, 
although they have been recommended hy the earlier as well as hy later g^uve meth- 
writers, and although the indications they are meant to fulfill have been o^^,. however 
an object of attention to the practitioners in all ages, yet I do not think sufflcienul 
that the extent of their utility has been always clearly perceived, or that atel/^^^' 
their administration has been always properly directed (p. 27). 

294. Another objection to the use of purgatives is urged with a force 

that seems to carry conviction along with it. It is observed that tlie reguZtel\iQ 
constant application of stimulating articiles creates a habit not f^nly of of^purgadve 
using them, but entails also the necessity of occasionally increasing their medicines, 
stimulating power. Habit or custom will indeed reconcile us to the im- 
pression produced* by unusual stimuli, and will counteract their effect in 
such a manner, that if the stimulus be suddenly withdrawn, or, which 
is the same thing, be not gradually increased, the functions of the organ 
to which it had been applied will become languid and irregular. This 
law of the economy no doubt extends to the promiscuous use of purga- 
tives given unnecessarily during the enjoyment of perfect health. In 
many instances, however, of disease, constipation and accumulation of 
fseces demand this stimulus to restore the healthy state of the intestines, 
and to promote the expulsion of their indurated contents. In propor- 
tion as these objects are accomplished, the stimulus from the same pur- 
gative becomes more and more powerful ; and so little is the necessity 
for continuing it, or for increasing its dose, that, on the contrary, were 



How excre- 
mentitious 



78 THE DOCTRINE OF PURGATION. 

not the activity of tlie purgative diminished, or were it not withdrawn 
altogether, as convalescence advances, we should be in danger of in- 
ducing weakness bj an excess of purging (p. 29). (Cf. Hipp. 16.) 

295. Purgative medicine»^ properly administered, will not induce 
REMo^^^^^de- debil'ty J on the contrary^ the bowels being excited to propel their con- 
hiiity. tents, their functions are restored, appetite and digestion improved, and 

the patient, so far from being weakened, is nourished, supported, and 
strengthened. (29.) 

296. Purgative medicines have also been thought unnecessary on 
this account, that in many diseases little food is taken ; and, therefore, 
regular alvine evacuations are neither requisite nor to be expected. The 
residue of food unfit for the jpur pose of nutrition contributes^ no doubt ^ its 

^t Ins art share of feculent matter / yet the abundant secretion from different or- 

"^Sthout gcii^8^ and the exhalation of excrementitious fluids made into the cavity 

much food, of the intestines^ constitute the bulk of the faeces collected within them. 

^L^uS- So long, therefore, as fluid is supplied, and so long as the circulation is 

^^^- supported, it is equally easy to understand how faeces are produced, 

independently of much solid food, as to perceive the necessity of their 

daily evacuation during the course of fever, and of other diseases of 

long continuance (p. 30). 

297. I refer the superior utility of purgatvve medicines in typhus 
fever to the circumstance of their operating throughout the whole extent 

fJoer^^^ of the intestinal canal^ the healthy functions of which are essential to 
Pwrgation ^]^q recovcrv, iu a manner that is consonant to the course of nature, by 

cures, and ^^•^. V ' n. -^ i t t , . • i 

why coriHo. propclling its coutcnts irom above downwards, and to their movmg and 
nunt^ to '^ '■•(.Qj^pigi^eiy evacuating the feculent matter, which in this case becomes 
offensive and irritating (p. 35). 

298. More extended experience confirmed these conjectures ; and I 
fr^T^g^n- was gradually encouraged to give purgative medicines during the course 
ningtoend. ^f typhus from the Commencement to the termination of the disease 

(ibid.) 



Full pur- 



299. I have directed a strict attention to this practice for a long 
time, and I am now thoroughly persuaded that the full and regular 
gatiou fits evacuition of the bowels relieves the oppression of the stomachy cleans the 
^effecu!^^ loaded and parched tongue^ and mitigates thirsty restlessness, and heat of 
surface, and that thus the later and more formidable impression on the 
nervous system is prevented, recovery more certainly and speedily pro- 
moted, and the danger of relapsing into fever much diminished (ibid.) 

Purgation ^^^- Fc)r many years past I have found wine to be less necessary (in 

T/rrS'^^e- typhus fever) than I formerly thought. . . This chiefly attributed to the 

moving de- purgativc mediciucs which I employed with freedom, obviating and re- 

buity. moving symptoms of debility. This doctrine is at variance with that 



THE DOCTRINE OF PURGATION. 



79 



which is commonly entertained, but I am confident it is consonant to the 
fact (p. 36). 



301. The complete and regular evacuation of the boivels, in the course ^eSg 



oi fever ^ is the object to be obtained (ibid.) 



Purgation 



needful in 
fever. 



302. T\\Q early exhibition of pv/pgatives tqWqyq^ the first symptoms, 



Early pur- 



prevents the accession of more formidable ones, and thus cuts short the ^^^^^^^ 
disease (p. 3Y). 



gallon an 



303. I had learned that the symptoms of debility which take place in purgation 
typhus fever ^ so far from being increased, were obviously relieved by the ifjlty^-^ %'. 
evacuation of the bowels. I have never in scandatina, in a long course of p'j;^* / cures 
experience, witnessed sickness and fainting, which some authors have so ver, and 
much dreaded; neither have I observed revulsion from the surface of 



the body and premature fading, or, in common language, " striking in " 
of the efflorescence, to follow the exhibition of purgatives (p. 45). 

Accordingly no variety of the disease has hitherto prevented me 
from following out this practice to the extent which I have found neces- 
sary (p. 46). 



causes no 
striking in. 



304. Purgative medicines are useful in removing dropsical swellings dropsical 
the consequence of scarlatina, when the weakness of the patient is often sweiimg 
very great. Purgatives also afford a means of preventing this swelling, aEemoved 
and other derangements of health (ibid.) 



by purga- 
tion. 



305. When I consider the languor and lassitude which precede mar- 
asmus., instead of adopting the common opinion of its being occasioned 
by worms, I am more disposed to think that a torpid state., or weakened^ 
action of the alimentary canal., is the immediate cause of the disease. 
From this proceed costiveness^^ distention of the bowels, and a peculiar 
irritation, the consequence of remora of the fcecesj and I have accord- 
ingly been long in the habit of employing purgative medicines for the 
cure of marasmus y the object is to remove indurated and foetid faeces, 
the accumulation perhaps of months, and as this object is accomplishing, 
the gradual return of appetite and vigor mark the progress of recov- 
ery (p. 59). 



Marasmus 
from torpid 
bowels, con- 
sequent, dis- 
eases and 
their cure by 
purgatives. 



306. Epilepsy, than which no disease is so afflicting to the patient, is 
frequently the effect of particular irritation of the mind or body. Prac- 
titioners enumerate worms in the intestines, or marasmus, among the 
causes of epilepsy. Surely this will induce us, on the first attack of epi- Purging 
lepsy in children, arising from an uncertain cause, to set on foot the most to^be 'taken. 
decided and active course of purgative medicines, lest we perad venture 
allow the disease to strike root, while we are idly employed in the exhi- 
bition of inert and useless vermifuge medicines, or are groping in the 
dark in quest of other causes of the disease, or of uncertain remedies 
for their removal (pp. 63, 64). 



80 THE DOCTRINE OF PURGATION. 

307. Chlorosis. — The slightest attention to the history of the disease 
evinces that costiveness precedes and accompanies the other symptoms. 
Costive /less induces the jecident odor of the breathy disordered stomachy 
f^JlL'^I *'"*" ^'^^^ ^f appcilte^ and impaired digestion. These preclude a sufficient 
supply of nourisMnent at a period of growth when it is most wanted ; 
hence paleness^ laxity^ flaccidity, the nervous symptoms^ wasting of the 
Qnuscidar fleshy languor^ debility^ the retention of the menses^ the suspen- 
sion of other secretions^ serous effusions, dropsy, and death (p. 11). 



Chlorosis 

Fearful re- 
ilts of 
tiveness 



308. The greater capacity of the female pelvis gives more room for 

that part of the intestinal canal which is contained within it to dilate, 

requirTf nil aud, of courso, to admit of greater accumulation of feculent matter, which, 

purgatwn^ Iji pj.Qpg-pfiQi^ f^ {fg femora, becomes more and more abundant, and more 



Women 



more 
mea. 



impacted. Hence costiveness is more obstinate, and chlorosis and other 
clise (ses originating in costiveness, are more severe and are of more diffi- 
cult cure in thefer)iale than the male (p. Y2). 

To escape ^^^- Grrcat attention and assiduity is requisite in the exhibition of 

failure purfi^ativo mediciucs in chlorosis, and the frequency of its repetition must 

ixj and fear- bc Varied accordiug to circumstances, w^hich can only be ascertained by 

lessiy. ^i^Q inspection of the " alvine egestaP The practitioner who is not aware 

Inspect ^^ ^^^% and who, yielding to the importunity of his patients, or the 

TEE STOOLS, caprice of their relations, does not steadily pursue his plan of cure, will 

be disappointed, his abilities will be called in question, and his practice 

vilified and neglected (p. Y3). 

310. The symptoms (of hysteria) undoubtedly denote a preternatural 
an^^airits offcction of the stomach and alimentary canal. In my opinion they 
^m™?ed™b^^ afford conclusive evidence that this affection is primary, and that the 
purgation, other iTiultifarious symptoms of hysteria depend upon it (p. 87). The 

first purgatives that we use may seem on some occasions to aggravate 
gSve^lrri- ^^^ symptoms, but the practice must not be deserted on that account. 
tation soon The additional irritation which pier gati'iSes r)%ay give in the first instance 
soon passes away, and perseverance in the use of them removes that irrita- 
tion which gave rise to the disease, which, of course, disappears in pro- 
portion as the bowels are relieved of the oppressive mass of accumulated 
faeces (p. 88). 

311. St. Titus' Dance. — Powerful purgatives must be given in suc- 
cessive doses, in such manner that the latter doses may support the effect 

St. Vitus' of the former, till the movement and expulsion of the accumulated mat- 
Let the ter are effected, when symptoms of returning health appear. Whoever 
S'^SSS undertakes the cure of chorea by purgative medicines must be decided 
C'^^'fr' doses and firm to his purpose. The confidence which he assumes is necessary 
dangerous, to Carry home to the friends of the patient conviction of ultimate suc- 
and^^Sve- cess. Their prejudices will otherwise throw insurmountable obstacles in 
his way. Half measures in instances of this kind will prove unsuccess- 
ful, and were it not for perseverance in unloading the alimentary canal, 
the disease would be prolonged, would place the patient in danger, and 
thus bring into discredit a practice which promises certain safety (p. 97). 



rancs sue- 
\Hj'ul. 



THE DOCTRIiNK OF PURGATION. 81 

312. The agonizing spasms, the prominent symptoms of tetanus, hav^ 
arrested the notice of every one. To resolve the spasm and to cure the cannot be* 
disease have been conceived to be one and the same thing. Accordingly, ,, Ss/S?- 
opium, musk, v^arm bathing, cold bathing, and mercury, have been em- modicH^' 
ployed in tetanus. But have they mitigated the severity of tetanus or ^md^ /uii 
obviated its fatal tendency ? " The records of physic bear a sad testi- ^^^J7««*"^^- 
mony in the negative." However just these observations may be, I 
should yet have been sorry to have advanced anything to shake the tot- 
tering fabric of medical practice in tetanus unless I, thought it had been 
in my power to substitute one more efficacious, originating in other terin^g^fabSc 
views of the disease. These views, I apprehend, will warrant the expec- ^^^ ™.^f ,<i*^ 
tation of considerable 'benefit from the full and free exhibition of purga- 
tive medicines (pp. 107, 108). 



practice.' 



313. Under the impression which I entertain of the utility of pur- Hydro- 
gative medicines, and of the inefficiency of the tonic plan of treatment ^ Antispas- 
in tetanus, no doubt remains with me respecting the mode of attempt- J^gs^i^ppR^Q^E.' 
ing the cure of hydrophobia, which has hardly in any instance yielded 

to the mostpowerfid antispasmodics. Purgatives are proposed to remote 
a cause which frequently induces^ and which may always aggravate 
spasmodic affections (p. 123). 

314. Palpitation of the heart merits particular notice in this place. 

I have witnessed the efficacy of purgative medicines in the most forbid- PaipUa- 
ding and apparently desperate instances of the ailment, in so much, hSt.^^ The 
that I am not now disposed to despair of any case, till I am satisfied JJJj;f^ *'*^®* 
that purgative medicines have been fully employed, and employed in 
vain (p. 122). 



An APPEAli 
TO ALL 



315. I am persuaded that the preservation of regularity in the alvine 
evacuation, will at all times prevent the accession of those diseases (pre- 
viously enumerated). If these expectations be not too sanguine, it is ., 
likely that the marasmus and chlorosis, the vomiting of blood, chorea, hovi&is'regu- 
and hysteria, of which I have spoken, will rarely, if ever, appear. It ^pr^ent^&\\ 
is fitting, therefore, that this observation should be widely spread, that ^ovmsotdia- 
it should be conveyed to mothers and nurses, to superintendents of nur- 

series, of manufactories, and of boarding-schools, and to all instructors 
and protectors of children and young people, and strongly impressed on 
their minds, by such of their medical advigers as think with me, and 
who will acknowledge that to prevent disease is the paramount duty 
(p. 125). (Cf. Sanctorius, Aph. 1., Sect. I.) 

316. The practice which leads to this conclusion (the free use of pur- 
gatives in the case of diseases), is presented in a simple form. It is nei- gatim pZn 
ther disguised by hypothesis, nor obscured by the simultaneous employ- ^if^^^'^f^ofs 
ment of various remedies. At the same time it is supported by proofs irrefraga- 
of unquestionable authenticity, which are not surpassed by any in the 
records of medicine. On these accounts, the truth or fallacy of my 
opinions may be easily investigated, and an adequate judgment of then) 



82 THE DOCTRINE OF PURGATION. 

readily formed (p. lltt). Here follow upwards of fifty cases of cure in 
various diseases, extracted from the records of the Royal Infirmary. 

Chronic ^^^' "^^^^ ^t^<^cly exMhitwii of jpurgatwe medicines is absolutely nec- 

^uea^e* re- essary to the success of the practice in chronic diseases. The puny state 
/)Xv7 ^plr- of the sufiferer may on some occasions excite alarm in the breast of the 
gation. . practitioner ; and the caprice of his patient, and the whims of relatives, 
may oppose obstacles to his conducting the cure in the most advantage- 
ous manner. But these he must disregard ; for unless he can suppress 
his own improper feelings, and overcome the unreasonable objections of 
others, he had better not adopt measures which, to prove successful, must 
Haifmeas- te couducted With fivmness. A contrary conduct will necessarily term- 
SsCTedit"oI inate in the vexation of the practitioners, in the disappointment of the 
the cause, patient and of his relatives, and in the discredit of that practice which 
it has been my wish and study to recommend (pp. 124, 125). 

Location ^1^- Discascd actions depend on the nature of the impressions, the 

thf nat!i?e^of P^^^^ ^^ which they are made, and on the constitution of the patient, 
the disease. The Same impression applied to different parts of the body may produce 
different actions ; cold to the extremities producing chilblains, or gan- 
grene ; to the head catarrh ; to the chest cough or pleurisy (p. 125). 

319. To conclude, the reader must have observed the beneficial 
Facts alone effects of purgative medicines, in diseases apparently different, and inci- 
uabS^^^scI^ dent to people at various periods of life. The facts are undeniable, and 
enc6. serve to prove the extent and importance of the subject ; but of these I 

do not feel it to be incumbent on me to give any explanation at present. 
Such an attempt might be premature. I am satisfied to have established 
certain leading facts, and to have opened views which, if properly pros- 
ecuted, must give an opportunity to extend our knowledge respecting 
the utility and administration of purgative medicines. It will then be 
Pracucai time to generalise the facts, and to form a system of medical doctrines 
^riTlt ^^ ^^^^ clear and comprehensive, and thence to deduce practical pre- 
sede theoret- ccpts useful in proportion as they will be simple and precise. When 

^^d^^simple THESE EXPECTATIONS ARE FULFILLED, OUR POSTERITY MAT SEE DECEPTIVE 
^SbMsrS^ REASONING, HOW INGENIOUS SOEVER, BANISHED FROM THE SCHOOLS OF 
the^materia MEDICINE, AND FROM THE PRACTICE OF THE HEALING ART A MULTIFARIOUS 
^ ^' PRESCRIPTION OF INERT AND NAUSEOUS MEDICINES (pp. 125, 126). 



IMPOETAN^T SERIES. 

McMuLLM, Joan, M. D., On the treatm^t of Chm^ea Sti. Yiti, hy 
^rgatives. See Edinb. Med. and Siflfe. Journ., 1805, Vol. I. 

320. Many diseases of syrajptomatic debility, which have resisted the 
The ton'c nse of tonics, have either been considered as incurable, or our failure 
^zoTt a fail- -j^^g been ascribed, not to our pursuing an erroneous method of treat- 
ment, but to our means having been too feeble, or employed too late ; 
and obstinately persisting in the tonic plan, on each succeeding occasion, 



St Vitus' 



lur 
Strengthen, 



THE DOCTRINE OF PURGATION. 83 

we push it with greater vigor and with the same want of success. There 
are, however, fortunately, practitioners who act more philosophically, and 
regarding with distrust theories which do not stand the test of experi- 
ence, endeavour to advance the science of medicine by the slow but sure 
method of observation and induction. It is in this way that wo some- 
times find a disease yielding to a plan of treatment diametrically oppo- 
site to that which the established opinions concerning its nature would 
have suggested (p. 25). 

321. With the view of alleviating the sufferings cf'^hose laboring 
under similar complaints, and of correcting the erroneous ideas enter- dance. 
tained of the nature of the disease, I am induced to publish some 
observations which occurred to me in consequence of having witnessed 

the cure of some cases of Chorea Sancti Viti in the Koyal Infirmary of 
this place (Edinburgh). In these cases, a mode of treatment was adopted cure by 
which no opinion of the disease hitherto published seemed to authorize ; ^golilH^—' 
although in every instance it was attended with the most marhed advan- ^Sufa^te"''^ 
tages. This treatment consisted in the repeated frequent exhib'/twn of 
drastic purgatives, which will appear on perusing the following cases 
not to have had the effect of debilitating still more an apparently debili- 
tated system ; but on the contrary, during their employment the jjaiient 
recovered strength, the involuntary motions gradually abated, and hy 
persisting in this treaim^cnt for a short time, a perfect cure was ejected. 
What is particularly worthy of observation, is the appearance of the al- 
vine discharges, which in every instance was blach and fetid (p. 26). 
Here follow five cases. 

322. From these cases, the following facts seem to be established : General 

1. From the exhibition of even two or three cathartics, the involun- advantages 

• 1 1 7 7.7 iroxapurya- 

tary motions and other symptoms were much abated. tiun. 

2. Although the cathartics were continued daily for a considerable 
length of time, the patient, instead of becoming more debilitated, became 
stronger and walked with a firmer pace. 

3. During the progress of the cure, if at any time the cathartics did 
not produce an evacuation, the involuntary motions recurred, and all 
the symptoms were aggravated. 

4. The faeces before the exhibition of the cathartics, were small in 
quant'ty, required a large dose of the purgatives, and in every instance 
were black and fetid. And lastly, 

5. When the disease was cured, the appearance of the fceces became 
natural (p. 30). 

323. Upon the whole, the connection of the disease with the state of 

the intestinal discharges seems evident ; and as in all the five cases fetid, Disease 
dark-colored evacuations preceded the cure, it would appear that, with ^tuJ^i i^^i'. 
them, the cause of the disease was removed. We may, therefore, legiti- '■*^^*- 
mately conclude that the involuntary motions, debility, and other symp- 
toms,, were in these cases produced by local irritation in the bawels, 
which was afterwards communicated to the whole system, through the 
medium of the nerves (p. 31). 



84 THE DOCTRINE OF PURGATION. 

324:. All systematic writers have considered chorea as a disease of 
and^^pi\rg!f- delnUixj^ and the same opinion has been almost universally adopted by 
com^a?ed"^. pi"i<^*^i^''^l pliysicicxns, who, seeing their patients laboring under evident 
debility, have ransacked the whole materia medica for tonics and anti- 
spasmodics. Under this treatment^ chorea has alw^ays been considered 
very difficult to cure. N"ow, when we compare the frequent failures of 
the tonic plan of cure with the invariable success of the purgative, we 
must conclude, in direct opposition to the hypothetical dogma of Brown, 
that the syniptoms of chorea do not depend primarily on debility, but 
that the debility is merely symptomatic qf the disease. But in whatever 
manner the phenomena of these cases may affect the theory of the dis- 
ease, they establish incontrovertibly a much more important conclusion 
— that it yields readily to the repeated and continued use of drastic 
purgatives (pp. 33, 34). 

Abernethy, John, M. D., Surgical Observations on the Constitutional 
Origin and Ireatment of Local Diseases, London, 1806. Eighth 
Edit, 1826. 

325. That the stomach and bowels are disordered by injuries and dis- 
Sympathy ^CL^cs of the parts of the body has been remarked by various persons ; 
between the \)^i tlic subject has ucvcr bccu extensively surveyed, nor viewed with 
other parts that accuracy of observation which its high importance merits. It has 
of the body, "j-^gg^ obscrvcd that sprains of tendinous or ligamentous parts produce 
sudden sickness ; and Mr. Hunter has attributed that shivering which 
is consequent to accidents, and attendant on some diseases, to the state 
of the stomach. It is known that in some local injuries from accident or 
operations, the stomach has appeared to be the part principally affected. 
But remarks on the affections thus induced in the digestive organs have 
been made only in a cursory manner. ... It also appears to me, that 
the connection of local diseases with the state of the constitution in gen- 
eral is either 7iot sufficiently understood, or not duly rega/rded by the gen- 
■ erality of practitioners (p. 5). 

326. The operation for hernia (in a certain case) was followed by 
Hernia g^^^^^^ disorder of the system, manifested by a full and strong pulse, 
from accu- furred tongue, great anxiety, restlessness, and total want of sleep. The 
fSid ''X'Uer stomach was particularly affected, being distended, uneasy on compres- 
Vf^pJrsevfr- sion, and rejecting everything that was swallowed. He was bled largely 
"uT ^u f ^ ^^ evening, and took saline medicines, but could not be prevailed 
p'ian. ' upon to swallow anything else except some toast and water. The sick- 
ness had in some degree abated on the next day, a solution of sulphate 
of magnesia in mint-water was prescribed, in small doses, given at regu- 
lar intervals, in order to relieve the disorder and distension of the stom- 
ach by procuring discharges from the bowels. In the course of the day 
the salts were administered which were not rejected by the stomach ; 
yet he could scarcely be prevailed upon to take anything else. The 
tongue was still covered with a thick yellow fur ; the skin was hot and 
dry, and the pulse frequent. As there was no particular tenderness 
about the epigrastic region, he w^as not again bled. The second night 
was passed without sleep. As the salts had produced no effect, the same? 



THE DOCTRINE OF PURGATION. 85 

medicine was ordered in an infusion of senna, with the addition of some 
of its tinctm-e, which by being given in very small doses, was. retained. 
When, however, it seemed likely that no effect would result from this 
medicine, a grain of calomel was given at night, and repeated on the 
following morning. Still the loathing of food continued. The third 
night passed like the former ones without sleep, and in great anxiety. ' 

On the next morning two pills, containing five grains of the pil. colo- 
cynth and the same quantity of the pil. aloes cum myrrha, were given 
every fourth hour. They procured no stool, nor produced any sensation 
which inclined the patient to believe they would operate. Again he 
passed a sleepless night, but toward the morning he felt his bowels 
apparently tilling, to use his own expression, and a profuse discharge 
ensued. A dozen copious^ fetid and hlach evacuations tooh jplace 
hetween Jive a/nd ten dolock^ and he had several others in the course 
of the day ; after which his ajpjpetite returned^ his tongue hecame clean, 
and a sound and pleasant sleep succeeded, from which he awoke appa- 
rently well (pp. 7-10). 

327. It is most probably the disorder of the hrain first affects the 
stomach ; but the reaction of the latter affection is liable to increase and ^^ ^j^^^^ 
maintain the former, by w^hich it had itself been produced. The effects «ys^em sym- 
that result from the sympathy of the whole constitution with local with \i!\-^- 
disorder vary greatly both in nature and degree (p. 8). I could relate ^^ ^^^^' 
numerous cases in support of the inference, that local irritation acting 

on the nervous system may affect the digestive organs in a very serious 
manner, and thereby create great disorder of the whole constitution, 
which is afterward alle^dated in proportion to the amendment that en- 
sues in the state of those viscera. Such cases of great local irritation must 
frequently occur to every, one ; it is, therefore, unnecessary to adduce 
more instances to support the opinions here delivered (p. 12). 

328. Witli respect to the treatment of cases of this description, it 

may be right to add, that the primary object should be to produce secre- oiS^^TjiZt 
tion from the irritahle organs. In the case which has been related, and *^^^°^^*^ ^^ 
in many others recorded in this volume, the effect of secretions from the opuim but 
disordered organs in relieving their irritable state is very manifest. In 
many instances opium will not prevent the continual efforts to vomit, yet 
when by sulphate of magnesia, or purgatives administered in the form 
of pills and clysters, stools are procured, the vomiting ceases^ the stom- 
ach retains both food and medicine, and general tranquillity of consti- 
tution is as suddenly restored (p. 13). 

329. A slighter degree of disorder occurs in the advanced stages of 
lumbar abscesses, diseased joints, compound fractures, and _all kinds ^^^^f^^v 
of local disease, which impart considerable and continued irritation to 
the whole constitution. "We also find a less important disease, as, for Sfe dSsTi^e 
instance, a fretful ulcer, keep up a disorder of the system in general, ^^'s^^^- 
and of the digestive organs in particular, which subsides as the irritable 

state of the ulcer diminishes (p. 17). 

330. If the Irain and nervous system should be disordered, without The nerv- 
any apparent local disease, similar derangements may be expected to and th?d^ 
take place in the functions of the digestive organs (p. 18). gestive or- 



hy purga- 
tives. 



ternal dis- 
ease in con- 



86 



THE DOCTRINE OF PURGATION. 



Thorough 
examinatiou 
of the pa- 
tient neces- 

" f^estlfss- 
neft-i and 
iierroH - 

jjexs" from 
disordered 

digestion. 



331. Patiejits commonly declare that they are in good health, except 
that they feel disturbed by their local complaints ; yet they are found, 
on inquiry, to have all the symptoms which characterize a disordered 
state of the digestive organs. The mind is frequently irritable and des- 
pondent ; anxiety and languor are expressed in the counter) ance. The 
pulse is frequent or feeble, and slight exercise produces considerable 
fatigue and perspiration. The patients are sometimes restless at night, 
but when they sleep soundly they awaken unrefreshed, with lassitude, 
and sometimes a sensation as if they were incapable of moving. Slight 
noises generally cause them to start, and they are, to use their own ex- 
pressi(m, " very nervous." These circumstances seem to indicate weak- 
ness and irritability of the nervous and muscular systems, which, in 
addition to the disorder of the digestive organs, are the chief circum- 
stances observable relative to the general health. JBy Gorrecti7hg the 
ohvious errors in the state of the digestive organs^ by the judicious 
administration of purgatives, local diseases^ which had baffled all 
attempts at cure by local means, have speedily been removed, and the 
patient has acknowledged that such an alteration has taken place in his 
general health as greatly excited his surprise (pp. 21, 22). 



Imperfect 
digestion — 
various ef- 
fects : pro- 
duces gas; 
impoverish- 
esthehlood; 

ditsorders 
the brain, 
the muscu- 
lar system, 

&G. ; i. e. 
causes local 
diseases. 



Indigestion 
or conntipa- 

t'um — ^fur- 
ther effects 
of. 



332, "When digestion is imperfect, gaseous fluids are extricated from 
the alimentary matters. Vegetable food becomes acid, and oils become 
rancid. Uneasy sensations are also felt, and undigested aliment may be 
found in the faeces (p. 24). 

Imperfect digestion m^ust influence the qualities of the hlood, and all 
parts of the body may be affected from this source (p. 65). 

Disorders of the digestive organs may produce, in the nervous sys- 
tem, a diminution of the functions of the brain, even so as to produce 
apoplexy and hemiplegia (p. YO). It may produce, in the muscular sys- 
tem, weahness, tremors, and palsy, or the contrary affection of spasms 
and convulsions. It may excite fever, by disturbing the action of the 
sanguiferous system, and cause various local diseases, by the nervous ir- 
ritation which it produces, and by the weakness which is consequent on 
nervous disorders or imperfect chylification (pp. 71, Y2). 

333. Being in a warm and moist place, the undigested food wdll un- 
dergo those chemical changes natural to dead vegetable and animal mat- 
ter ; the vegetable food will ferment and hecoine acid, the animal will 
grow ranc'id and putrid. . . These effects must continually take place, 
unless, by the digestive power of the stomach, the food is converted into 
a new substance which is not liable to these chemical changes. Such 
irritating compounds cannot fail to be detrimental to the whole tract of 
the alimentary canal. Part of the food thus changed will be absorbed 
from the bowels and render the blood impure, from which there is no 
outlet for various kinds of matter but through the kidneys, and this may 
prove a cause of foul urine, as well as of the presence of many sub- 
stances in that fluid not natural to it (pp. Y4, 75). 



All pur. ^^^' P^i'sons may be purged without having their bowels cleared of 
gatives are the fccal matter which may be detained in them. We should therefore 
efficient!^ ^ cudcavor to ascertain what kind or combination of purgative medicine 



will excite a healthy action of the bowels (p. 89). 



THE DOCTKINE OF PURGATION, 87 

335. T\\Q prmciple that should govern our conduct in the adminis- now to r^ 
tration of purgatives may be briefly stated ; the excitement is to he re- Sministrl'?^ 
peated till the requisite action is induced, yet no single excitement being gaSy'^^'''^' 
such as may prove an irritant to the organs (ibid.) 

336. I am aware that laxative medicines may relieve irritation merely 

by augmenting the natural secretions of the viscera, and thus unloading Laxative 

their vessels ; and also by determining the fluids from the head, when X^&'^l^tS^ 

the nervous symptoms are aggravated by a plenitude of the vessels of 

the brain. As I have found the lenient plan of treatment — that of ex- The lenient 

citing the peristaltic action of the bowels, so as to induce them to clear 

out the whole of their contents, without irritating them (so as to produce 

what is ordinarily called purging), particularly successful — I have rarely 

deviated from it. I am not, therefore, warranted from experience in 

speaking decisively respecting the more free use of purgative medicines 

(pp. 90, 91). 

337. The most judicious treatment will not remedy the disease if the Disease 
exciting causes continue to operate — such as improprieties of diet, agita- cS whi^e 
tion of mind, sedentary habits, or impure air (p. 96), jfontinueT^ 



plan. 



What is 
necessary 



338. It is necessary to the cure of disorder, first, that the stomach 
should thorouffhly diei-est all the food that is put into it ; secondly, that 
the residue of the food should be daily discharged from the bowels for cure?' 
(pp. 99, 100). 

339. The profuse discharges which sometimes follow the continued 
exhibition of purgatives consist of morbid secretions from the bowels character 
themselves, and not of the residue of alimentary matter detained in uont^^^^^^ 
those organs (p. 35). 

The stools, which resemble pitch, are principally composed of diseased 
secretions y'/'^wi the internal surface of the intestines (p. 36). 

340. All the experience which I have had relative to the treatment Tetanus 
of tetanus (locked-jaw) has convinced me that more benefit is obtained by ^^^^^^^^^^^' 
correcting the errors of the digestive organs than by any other means. It Purgation 
may be useful to mention one case as a striking proof of this fact : A aiT^eSemS 
man who had been wounded in the foot, was brought about ten days 
after the accident to the hospital, and so violent and general were the 
spasms that it was scarcely expected he could be taken to his bed alive. 
The jaw was fast clenched, and the muscles of his back and belly rigid ; 
convulsive actions came on frequently, and then all his limbs were vio- 
lently aifected. His bowels had not been relieved for many days. When, 
after twenty hours, his bowels were purged, the discharges were not like 
faeces, and so extremely oflfensive that the patient could not stay in the 
ward. From this time, however, there was a complete subsidence of the 
spasm, and \)i\Q patient recovered seemingly in proportion as the digestive 
organs regained their healthy functions (p. 130). 



lesions. 



341. A female patient, about twenty-seven years of age, was lately 



Paralysis 

admitted into the hospital for paralysis of the arm, whiciriiad come ovi le'Ted Sl% 
suddenly. She complained of much pain when pressure was made along "Lf cur?by 



88 



THE DOCTRINE OF PURGATION. 



continued 
purgation. 



Chronie 
croup 
rurgen re- 
move the 
cause. 



the enter margin of the scalene mnscles, where the nerves emerge that 
form the axillary plexus. Her digestive organs were greatly disordered, 
and, in one week, l)y means that could only operate directly on those 
organs, she regained the nse of her arm (p. 132). 

A gentleman of the medical profession, whose digestive organs haa 
been long disordered, suddenly lost the use of his right arm, without any 
apparent disturbance of the cerebrum. A professional friend asserting 
that the paralysis was a consequence of the disorder of the digestive 
organs, the patient promised strictly to adhere to any course of medicine 
that his friend would prescribe. The only medicines ordered were pills, 
containing two grains of calomel, at night, and purges on the following 
morning, for one week. The bowels were cleared daily. On the sixth 
day, however, several copious, darh-colored and offensive discharges took 
place, and the patient immediately regained the use of his arm (p. 132). 

Blegbokottgh, Henry, Surg., On Chronic Croup. London, 1806. 8ee 
Med. and Phys. Jouen., 1806, Vol. XV. 

342. When the disease has subsisted some days there is generally 
thick and short breathing, with heat of skin and frequent pulse ; but as 
these symptoms are always relieved by a calomel purge, I conclude they 
are produced by loaden bowels. Being removed, they always in a few 
days return, and are, by the same means, again and again relieved 
(Journ., p. 509). 

Bkadley, James, Surg., On Hernia. Huddersfield, 1806. See Med. 
AND Phys. Jouen., 1806, Vol. XVI. 

343. Mr. Bradley gives seven cases of hernia in patients of different 
ages, sexes and constitutions, demonstrating his method of employing 
the taxis in inguinal or scrotal hernia. Generally costiveness precedes 
the hernia, and vomiting accompanies it. On the employment of pur- 
gative medicines he says : 

In case seventh, the cathartic solution was administered from evident 
symptoms of enteritis ; and here, as well as in case first, where this 
medicine was administered, I could not perceive any of those unpleasant 
effects ascribed to purgatives in general. The small quantity taken into 
the stomach not proving sufficient to increase the disorder of that organ, 
and the position in which the patients were placed, might tend, perhaps, 
in some measure to obviate any increased distress arising in that quarter. 
I gave this medicine, not with a view of obtaining any laxative effects, 
but as a cooling sedative, calculated to abate irritation in the first pas- 
sages, under the circumstances of a quick pulse, considerable thirst, and 
great pain in the abdomen. I was led to adopt this remedy in prefer- 
ence, from observing its good effects in enteritis, and in obstinate con- 
stipations of the bowels attended with colic, which I have seen it fre- 
quently remove, before any laxative effects have heen produced 
Journ., p. 48). 

■ Morgan, Charles, M. D., On the Use of Purgative Medicines. See 
Edinb. Med. and. Surg. Journ., Vol. II., 1806. 

Purgation 34-4-. Debility is itself an effect of disease, and, when the disease is 
\>my^ removed, the strength and vigor of the system will return. Have we 



Hernia. 
Purgatives 

useful as 
cooling sed- 
ativeft^ re- 
moving the 
irritation in 

the primEe 
viae, and pro- 
moting the 
reduction. 



THE DOCTRINE OF PURGATION. 89 

not often seen the debility which attends some of the complaints of in- 
fancy removed, as well as the disease of which it was a symptom, by 
evacuating the howels ; and nausea^ and anorexia, with all the depress- 
ing symptoms of dyspepsia, how often alleviated ly a Irislc purgative f 
(p. 100). 

345. If we would follow out this practice on general principles, we 
must emulate the whole effect of our remedies. Sometimes we empty the Effects of 
bowels simply ; at others we promote an increased secretion of fluids by JreeTofpS- 
purgative medicines. In some cases it appears suflicient to unload the 
bowels of their contents accumulated by long retention, and thereby 
relieve the system from the eifects of this local irritation ; but in others, 
and especially in those in which a freer and more continued purging be- 
comes necessary before the symptoms yield, we hring off not only the 
contents of the howels which are out of the course of circulation, we 
eliminate also the secretory organs which terminate in the intestin(^ 
canal — the obstruction, torpor, or deranged actions of which may have 
'been a chief cause of the morbid actions of other parts of the system 
(ibid.) 



gation. 



In propor- 



346. We are surely authorized to make this inference from cases in 
which the purging is continued for weeks, to the exhibition of three or tion ar*the 
four stools daily, with progressive relief of the morbid symptoms, with matZrs^re 
improved looks and strength, and at length followed by the perfect cure ^l^feamis 
of a complicated disease. In other cases we find the cure advancing restored. 
with the discharge of fetid stools of a bilious appearance, or black and 
greenish color (p. 101). 

34Y. Having been an eye-witness of Dr. Hamilton's practice, I could '^he danger 
not avoid being struck with its simplicity and success, and adopting it ^purgiZg^ 
as my own. Much dissatisfaction may have arisen among practitioners, «^#cie7i%. 
from the unwillingness of patients to submit to a repetition of purga- 
tives, who all esteem purging a debilitating operation, and think them- 
selves " far too nervous " to undergo it with impunity. Many too, I 
believe, are disappointed in their hopes of vure, by stopping short of the 
wished-for point (ibid 1807, vol. III. p. 144). 

348. Both these evils may arise from a neglect on the part of the ^^^^ 
medical adviser. I mean, not inspecting the stools. If the practitioner amTnl^m 
be too much an " emunctse naris homo " to submit to such a drudgery, ^*°^^^' 
let him go on trusting to remedies that have long failed, or rather let 
him lay aside the practice of medicine altogether. It is only by daily 
inspection of the stools that the purging can be regulated j for, as long as 
they exhibit moebid appearances, so long are purgatives necessary, 
and no longer. 

When the stools are not seen, the patient conceives that he is discharg- 
ing far more than you are aware of, and more than his constitution can 
bear. By an earnest inquiry after them and a strict injunction that the 
whole may be saved, together with an occasional appeal to the patient, 
whether such matters can remain in the body with impunity, I have 
never failed in inducing a cheerful submission to the plan, and the pa- 



90 THE DOCTRINE OF PURGATION. 

tieiit at last looks for tlie repetition of the doses as a sure relief from the 
misery he is siilFermg. Having premised these remarks, which arise 
from the objections of several medical friends, I proceed to the relation 
of two cases, not picked out as proving more than others, but as exhib- 
iting the obstinacy of the disease, and the ultimate advantages derived 
from a steady perseverance in the purgative plan (p. 145). Here follow 
the cases : 

. • 

Walsh, 'E., Jf. D. An account of a malignant fever, which appeared 
in the Garrison of Quebec during the Autumn of 1805, with some 
preliminary observations on the diseases of the Canadas. London^ 
1806. See Med. and Phys. Journ. 1806, vol. XV. 

Lake/ever. ^^^- ^<^^^ Fever. — The curo of this fever is not less easy and cer- 

Emetic and ^^iu at its Commencement, than difficult in its advanced stasres. An 
es. antimonial emetic, followed by a brisk purge, with attention to regimen 

lor two or three days, seldom failed of curing it on the access. But if 
this was neglected, and the disease far advanced, such a torpor of the 
system was induced as frequently rendered ineffectual the most active 
medicines (Journ., p. 448). 

Dr. Walsh characterizes the malignant fever at Quebec exactly 
like Mr. Bennion describes the fever at Gibraltar, and has employed the 
same remedies against it ; confer, therefore, Bennion on the Gibraltar 
Fever (Journ., pp. 451-453). 

Cheyne, J., M. D. Observations on the Effect of Purgative Medi- 
cines. London, 1808. See Edinb. Med. and Surg. Journ., 1808, 
vol. IV. 



I'iU antf 



tives. 



350. Case of a youth who, in consequence of a fall, was subject for 
inability To a yeo/p to mjost distressing fits, intense pains, etc., and who, in conse- 
hy purg^a- qucuce, had lost the power of walking. (Case given.) This boy in 
about two months w^as restored to health. During this period he used 
a great quantity of strong cathartic medicine. A scruple of aloes and 
ten grains of gamboge were^iven daily for several weeks before his 
stools became natural ; and as his stools became large, loose and natural, 
the fits left him and he recovered the use of his limbs. About the end 
of my attendance, when his bowels were acting more naturally, one pill 
of the same kind, of which it before required sometimes ten to produce 
the desired effect, was a sufficient dose (pp. 310, 311). 

In this case our practice is supported by analogies drawn from the 
successful treatment of other diseases where, along with convulsions or 
aff^uons!'^ spasmodic affections, we have also been able to detect a great degree of 
foulness in the bowels. It is in compliance with a common idiom that 
I use the expression of foulness of the bowels. I am persuaded that 
such a state cannot, with any propriety, be said to exist. Take the 
Infantile ,^iQy^ infantile remittent of D7\ Batter, or the marasmus of Dr. Ham- 
ilton- — we have a train of symptoms supposed to be induced by foulness 
of the bowels ; and the appellation seems to be countenanced by what 
is observed during the cure, the effects of the purging medicines 
Fetid stools, employed. By these medicines stools are procured, at first darJc^ slim/y 



marasmus. 



THE DOCTRINE OF PURGATION. 



91 



a/nd fetid^ which perhaps, for a considerable time, have nothing of the 
appearance of natural faeces ; the evacuations seem merely a collection 
of vitiated secretions, but at last^ hy pursuing the purgative plan^ large 
natural stools are evacuated, and it is generally supposed that these 
stools have been all the wliile lodged in the. intestines, and that our 
medicines were not powerful enough at once to expel them — that the dis- 
ease was solely from an accumulation of fecal matter (p. 312). 

351. But the fact is, that these critical stools are produced hy the 
restoration of the viscera to a healthy condition. The purgative medi- 
cine employed is useful, not so much by removing the accumulations.^ 
but that it stimulates the howels. By the steady application of this 
stimulus the visceral functions are restored. The bilious and slimy 
stools are expelled, the light food is concocted, and from the fecal resi- 
duum, with the increased supply of gall, of gastric and pancreatic fluids, 
and the secretions from the large intestines, in consequence of the reno- 
vation of the organs supplying these fluids, the large natural stools are 
produced and the disease resolved. Were the bowels in a healthy con- 
dition, they would be acted upon by what at all other times is their 
natural stimulus, and, consequently, they would not admit of this sup- 
posed accumulation. If there be accumulation, the torpid state of the 
intestines is the cause of it ; but the disease may exist without any accu- 
mulation whatever (p. 312). 

352. In dysentery., where hardened faeces are lodged in the bowels, 
we see a constant succession of unsatisfactory stools, and of these stools 
the hard fgeces or scybala would seem often to be the cause. For, it is 
observed by every practical writer, that when, by proper purgatives, the 
scybala are evacuated, there is immediately a remission of the most 
urgent symptoms, in particular of the tenesmus, and frequent mucous 
stools (p. 313). 



Powerful 
purgation. 



Critical 

evacuations 

hy stool. 



Critical or 
fetid stools 
indicate re- 
moval of dis- 
ease and re- 
turn of 
healthy ac- 
tion. 



Dysentery 

from 

scybala. 



353. Hydrocephalus. — The cure. The exhibition of the largest dose 
which can be safely prescribed of some powerful cathartic medicine., 
two, three, or four times a day ; and this continued for several days, or 
until natural stools are produced. The advantage of keeping the intes- 
tinal canal under the continual influence of a stim^ulus, I have, in 
various instances, found to be so great, that I am induced to repeat the 
declaration of my belief, that the happiest result may be expected from 
this measure. {Essay on Hydrocephalus Acutus, Edinb., 1808 ; ibid., 
p. 346.) 



Water in 
the brain — 
cure by the 
fullest pur- 
gation. 



Gat, M., M. D., An Essay on the Nature and Ireatment of Apoplexy. 
Paris^ 1808. Translated hy Ed. Copeman, Surg^with an Ap- 
pendix. 
XYI. 



London, 1843. See Brit, aj^d Foe. Med. Eev., 1843, Vol. 



354. This treatise proves that hleeding is injurious in aU cases of 
apoplexy, and that the primary cause is always to be found in the primes 
vise ; tlmt purgatives are indicated in every case, except when the attack 
follows a full meal, when emetics should be first administered (Rev., 

272). 



Apoplexy. 

Ntverhle&dy 

but purge. 



9'2 



THE DOCTRINE OF PURGATION. 



Halldday, Andrew, M. D., On Epilepsy. 
AND Phys. Journ., 1808, Vol. XIX. 



Blcmdford, 1808. See Med. 



Epilepsy 
h-om.iC0rms. 



Continued 
purgation 
removes the 
cause by 
carryingoff 
accumula- 
tion of 
onorhid 
onatter in 
the intes- 
tines. 



355. Case given of a girl of five years old who was subject to fits with 
violent contraction of the limbs, had an unnaturally voracious and de- 
praved appetite, and could articulate but very few words, however she 
understood what was said to her. 

Upon an attentive consideration of this case, it occurred to me that 
purgatives were likely to be of service, and from my intimate acquaint- 
ance with the practice of that justly-celebrated physician, Dr. Hamilton^ 
of Edinburgh, I entered upon the treatment with great confidence, and 
did not hesitate to promise success to the parents of the girl if they 
would faithfully and implicitly follow my directions. I confess that I 
had my fears lest there should be some organic disease ; yet the pulse, 
though rather slow, was regular. The bowels, I was told, were very 
irregular, but generally costive ; I felt the abdomen very tumid ; and 
notwithstanding the feebleness and emaciated state of the patient, I felt 
convinced that no time was to be lost ; I therefore ordered an active 
purgative. The fits recurring and no stool being procured, infusion of 
senna was given, one ounce every half hour, which produced several 
scanty^ fluid moUons, of a greenish color ^ and highly fetid. Both 
medicines were continued for four days, without alteration in the state 
of the patient or her bowels, several lumbrici were voided, the fits had 
rather increased in violence; on the fifth day she had two motions, the 
last very copious.^ consisting chiefl/y of hardened scyhala.^ and containing 
two worms ; fits returned only during the night. Three days more 
brought more large evacuations of the same kind, diminished voracious- 
ness, and less severity of fits which occurred during the nights. From 
this time (the 6th of January) to the 20th, I continued the exhibition of 
calomel and rhubarb, and the senna occasionally, never intermitting 
more than one day. The quantity of feculent matter which she passed 
during that period is beyond conception. Her appetite began to flag 
about the 14th, and on the 16th her mother informed me that she had 
not had a fit for twenty-four hours ; on the 17th she had one very severe 
fit, but remained free from them again till the 20th, when she had one 
which did not continue above ten minutes. During this period she had 
voided three lumbrici. The fits gradually abated, the appetite became 
natural, while purging pills were continued so as to secure a regular 
alvine discharge (Journ., pp. 305-308). 



Large doses 
SinA perse- 
verance se- 
cure 

SUCCESS. 



356. Thus far the purgatives have fully answered my expectations. 
The child appears to be cured of her fits, but I am afraid she will remain 
an idiot while she lives. The doses of medicine that were necessary to 
move her bowels were very large, and also the length of time which 
elapsed hefore the howels could be said to he properly moved, for I con- 
ceive that she had no proper motion till the seventh day. The large 
doses of medicine which were necessary may be accounted for, perhaps, 
from the state of the sensorium ; and the difficulty which there was in 
moving the bowels was, no doubt, owing to the great accumulation 
which had taken place (p. 308). 



THE DOCTRINE OF PURGATION. 



357. Though the fits are removed at present, I fear they will be apt 
to return, unless great GO/re is taken to keep her howels open for some 
considerable tiine^ until the predisposil/ionfrom habit is overcome, anct 
the bowels are restored to their natural tone / but if this is attended to, 
I ain certain the cure will be complete. This case, then, I would say, 
tends to corroborate the very valuable observations of Dr. James Ham- 
ilton, but indeed those observations stand in no need of any such testi- 
mony ; for Dr. Hamilton has proved every position which he has 
advanced by facts that never can be controverted. The novelty, the sim- 
plicity, a/nd the efficacy of Dr. HamiltorC s practice attracted much notice 
on the first appearance of his invaluable work ; and as the doctor did 
not venture to give his discoveries to the world till experience had most 
fully confirmed them, he was able to speak with certainty ; and I will 
venture to affirm that if purgatives hawe failed in any instance to piA 
duce the effects which Dr. Hamilton's observations have so incontestibly 
proved them capable of producing, that that failure is to be attributed 
more to the prescriber than to the medicine prescribed (Journ p. 309). 



It is neces- 
sary to estab- 
lish regv^ 
larity of al- 
vine evacua- 
tions in or- 
der to secure 
health. 



The purga- 
tive plan of 

treatment 
and Hamil- 

toTi's doc- 
trine vindi- 
cated. 



358. I liave often heard it argued, by those who were unwilling to 
give too much credit to Dr. Hamilton, as was generally allowed, that 
though no doubt the cases which he had related seemed to prove the 
good effects of purgatives, yet that many of those cases — for example, 
his cases of typhus fever — were so trifling that any other remedy would 
have done as well as purgatives. And, moreover, it has been often 
hinted that though this practice may do very well in the north, and in 
the Koyal Infirmary of Edinburgh, yet that it is by no means calculated 
for the delicate constitutions of this country. 1 shall only say, that 
those who have witnessed Dr. Hamilton'' s practice have been fully con- 
vinced of the good effects of purgatives in severe as well as slight cases 
of fever ; and, indeed, had the doctor felt any anxiety about this, he 
might have filled the second number of his appendix with cases more 
severe than any he has given. With regard to the second hint, I can 
add my testimony to that of Dr. Morgam., of Dover. (See Edinb. M. 
and S. Journ., 1807, April 1.) 

I have prescribed purgatives in different diseases since my residence 
in England, and have found their effects uniformly the same as in the 
north. While I resided at Halesworth, in Suffolk, I attended Robert 
White, of Walpole, with Mr. Walker, surgeon, in one of the worst 
cases of typhus I ever saw. The disease was speedily subdued by pur- 
gatives. The bolus jalapse compositus had the same good effect in Suf- 
folk as in the Royal Infirmary of Edinburgh (Journ., pp. 309, 310). 



Typhus. 



Further vin- 
dication of 
the purga- 
tive plan 
and Hamil- 
ton'' s prac- 
tice. 



Watt, Robert, M. D., Cases of Diabetes, Consumption, dsc, with Ob- 
servations on the History and Treatment of Disease in 
Paisley, 1808. See Edinb. Med. & Sukg. Jour., 1809, Vol. V. 



359. The functions of the lungs are twofold : to assimilate the new 
materials supplied by the digestive organs, and to preserve the blood in 
a healthy state. In health there must be a due balance between the di- 
gestive and assimilative organs. If this balance be disturbed, disease 
ensues (p. 93). 



The lungs; 

—health and 

disease. 



94 



THE DOCTRINE OF PURGATION. 



Ohy^C' 360. If more chyle be thrown upon the lungs than they can assimi- 

late, it must remain an incumbrance upon the system, or he discha/rged 
iSj one or other of the excretories (p. 94). 

361. The hlood may he deteriorated, and yet support life, in an im- 
perfect manner. The vessels which increase and repair the solids may 
be in want of proper materials, though the system w^ere overcharged 
with blood. The nervous system being deprived of its natm'al support 
from these vessels, acquires a depraved sensibility, and all the phenomena 
follow which we ,have described as attending a diseased habit. The 
greatest number of secreting organs are idle for the want of arterial 
hlood, the only stimulus %Dhich can call them into action. The liver 
receiving its stimulus from venous blood, has more to do than in health ; 

ice arise " bilious complaints " which, with low spirits, prostration of 
*ength, &c., generally mark the first stage of disease (p. 94). 

362. If the system possesses sufiicient vigor, reaction takes place; and 
goes on to a proper crisis. ... In place of fever the balance is often 
restored by a critical evacuation. If the superfluous matter take to the 
intestines, it produces dia/rrhma / if to the kidneys, diahetes / if to the 
uterus, menorrhagia ; if to the skin, profuse perspiration. If the re- 
action fail to produce a salutary crisis, the system falls back, collects 
new vigor and resumes the conflict, as in intermittent fever, and other 
periodical diseases. In other instances, such as hypochondriasis, it re- 
peats the same thing over again, or tries other means of relief, and is 
thus said to counterfeit every disease ; that is, it employs many efforts 
to throw off the incumhrance, but is generally unequal to the task. Af- 
ter a longer or shorter struggle, a conffrmed phthisis, diahetes, diarrhoea, 
dropsy, or some other disease, terminates the patient's sufferings (p. 95). 

363. In every period of the history of medicine, there has not only 
been practice opposed to practice and theory to theory, but one fashion 
has succeeded another with astonishing rapidity. One practitioner 
treats burns and scalds by heating, another by cooling applications ; one 
cures the gout by carefully wrapping the feet in flannel, another by 
plunging them in cold water ; one combats fevers with wine and opium, 
another by gruel and purgatives. These, though abundantly striking, 
are but a small sample of the oppositions in medicine. To notice the 
fashions would be to enumerate the various articles which, from time to 
time, have entered the materia medica, and almost every possible man- 
ner in which these can be prepared and compounded. (Journ, 1810, 
Yol. YI, p. 287.) 

AbayA'' spe- 364. From a belief that there is no disease without a corresponding 
cificsy remedy, medical men have been much in search of antidotes. The task 
of finding a specific for each disorder, reminds me of the labor of the 
Chinese in inventing a distinct character for every word in their lan- 
guage. However numerous and diversified the hair-splitting systems of 
nosology may represent diseases, the mea/ns of cure, like the simple 
sounds in language, are few o/nd ohvious. Galen remarked that hleed- 
ing a/nd purging were the two legs of physic, and it is douhtful how 

Purgatives /^^ ^^^ ^^^ ^^^ ^^^^ improvcd hy the legs which have since heen added 

ih^^'UgsoS (ibid.) 



The hlood. 



The nerves. 



Secreting 
organs. 
The liver. 
•' Bilious 

com- 
plaints" 
debility. 



Reaction. 

Ontical 
evacuation : 
Diarrhoea — 
intestines ; 
Diabetes — 
kidneys ; 
Menorrhagia 

— uterus ; 
Perspiration 
— skin. 
Hypochon- 
driasis — its 

causes, 
course, and 
end, if im- 
pu'ities are 
not remov- 



Vagaries of 
medical 
practice. 



I 



THE DOCTRINE OF PURGATION. 



95 



Beiggs, H., M. D., Physieicm of the Royal Dispensa/py of Liverpool ; 
History of a case of tetanus cured hy purgatives. Liverpool^ 1809. 



See Edinb. Med. & Surg. Jouen.. 



1809, Vol. V. 



865. Remarkable case of Luke Gaskell, given in detail. — The cure 
was perfect in four weeks. On the fourth day of the case, L>r. JBriggs 
says : — " I had all along been aware of the awful responsibility I in- 
currred by departing so widely from the usual practice in tetanus, and 
now my resolution failed me altogether. I was terrified with the ap- 
prehension that I had already delayed the free exhibition of opiates too 
long, while yet I was loth to relinquish the use of purgatives (p. 154). 
On a cool review, I asked myself whether, if the case should prove 
fatally, as I then feared it would, I could with justice affirm, that purga- 
tion had heen fairly tried a/nd failed, whether on the contrary the ex- 
acerbations that had occurred ought not to be ascribed to the interrup- 
tion of the plan, rather than to the plan itself? (p. 155). Finally, I con- 
cluded to adhere to the plan of purgation, and to discontinue the inter- 
nal use of opium (ibid). 

366. After the cure, he says : — '' If there be any point in medicine, 
on which, after having been engaged in dispensatory practice for sixteen 
years, I have arrived at any certain conclusion, it is this, that in gastro- 
dynia, and many other spasmodic affections, hrisJc purgatives will be 
found incomparably tetter antispasmodics than any of that tribe to 
which this epithet is usually applied. I believe, too, that their operation 
is strictly antispasmodic — that their first effect is, to supersede the 
spasmodic action ; for I have often known complete relief to be obtained 
before a stool was procured, in so much, that I have more than once 
been asked by patients, ' if I had not given them laudanum V '' (p. 161). 

I am inclined to think, that the more drastic purges were laid aside 
for no sufficient reason. . . The more active purgatives appear literally 
to have possessed antispasmodic virtues (p. 162). 

The quantity of medicine taken from first to last for twenty-five 
days is certainly very large, as follows : — calomel 320 grains, scammo- 
ny 340 grains, gamboge 126 grains, powdered jalap 6 ounces, infusion 
of senna with tincture lOf pounds, colocy nth-pill nearly 2 ounces, of' 
which the greater part was taken within the first week. 

During forty-eight hours (on the 5th and 6th days) was given scam- 
mony 210 grains, gamboge 89 grains, jalap IJ ounce, infusion of senna 
2|- pounds, calomel 80 grains ; and all this without causing sickness or 
griping, but on the contrary with most decided benefit (ibid.) 



Locked-ja/i/} 
— remark- 
able case ; 

cure by pow- 
erful jmr- 
gaiion. 

" Nil (lenpe- 
romdv/m,.'''' 



Spasms of 
the stomach. 



Purgatives 

the best 
" antispas- 
modics." 



Drastic 
purges. 



367. In short, if a remedy be indicated at all, surely the dose should be 
regulated, not only by' weight and measure, but by the effoct. And when 
there is such a strong concatenation of morbid actions, as in tetanus, it 
might perhaps have been expected, a priori, as it h.^'S, proved in fact, that 
nothing but the most active purges, in large doses, and freqtcently re- 
peated, would avail to break the train (p. 163). The whole quantity of 
opium taken was 100 drops in two days, and so far from answering any 
good end, it seems manifestly to have prevented sleep, as well as to have 
tmpeded the operation of the purgatives (p. 164). 

This is the most important evidence, in respect to purgatives, we have yet published. 
Our directions for the use of Brandreth's Pills need no modification. Dose, from 2 to 20, or 
any quantity required to purge. 



The effect, 

notthequan 

tity of the 

dose to be 

considered. 



unit. 



06 THE DOCTRINE OF PURGATION. 

Rush, Benjainiin. M. D., Medical Inquiries, 4 vols. Philadelphia, 
1809. 

iH^^ease a 368. There is hut one fever. However different tlie predisposing, 
remote, or exciting causes ot fever may be, still I repeat, there can be 
but one fever (vol. III., p. 16). 

All forms 369. I infer tbe unity of fever, further, from the sameness of the 
"^treJc.!'' pi'oducts or effects of all its different forms (ibid., p. 17). All ordinary 
sa!wumr- I'S'^'er being seated in the blood-vessels, it follows, of course, that all 
ous system, those local affcctions we call pleurisy, angina, internal dropsy of the 
brain, pulmonary consumption, and inflammation of the liver, stomach, 
bowels, and lungs, are symptoms only of an original and primary dis- 
ease in the sanguiferous system. The truth of this proposition is ob- 
vious, from the above local affections succeeding primary fever, and 
from their alternating so frequently with each other. There heing hut 
one fever, of course I do not admit of its artificial division into genera 
and species (ibid. p. 33). 

'^'arrarwe^^ 370. Pulmono/py consumption is sometimes t/ra/nsferred into head- 

mentsQi^%- achc, rheumatism, dia/rrhma and mania. The hilious fever often ap- 

tfonabie S pcars in the same person in the form of colic, dysentery, inflammation 

useless. ^£ ^^ liver, lungs and brain, in the course of ^yq or six days. Phreni- 

tis, gastritis, enteritis, nephritis, and rheumatism — all appear at the 

same time in gout and yellow fever. . . . Much mischief has heen done 

hy nosological arrangement of diseases. They erect imaginary houn- 

daries hetween things which are of homogeneous nature (ibid., p. 34). 

consequen- 371. They gratify indolence in a physician by fixing his attention 
ciai°no^^n- "upon the uamo of a disease, and thereby leading him to neglect the 
ciature. ranging state of the system. They moreover lay a foundation for dis- 
putes among physicians by diverting their attention from the simple, 
predisposing and proximate to the numerous remote and exciting causes 
of disease, or to their more numerous and complicated effects (ibid., 
p. 35). 

The mate- 372. T\iQ y^\io\q materia medica is infected with the ^<^^e/WZ <?c>^<9^- 
7^^^£t- quences of the nomenclature of diseases, for every article in it is pointed 
only^ against their names, and hence the origin of the numerous contra- 
dictions among authors who describe the virtues and doses of the same 
medicine (ibid). 

^fomtngr"^ 373. By the rejection of the artificial arrangement of diseases, a 

when the rcvolution must follow in medicine. Observation and judgment will 

mS^SiXl take the place of reading and memory, and prescriptions will be con- 

edgS^and ^"^^^ ^^ cxistiug circumstauccs. The road to knowledge in medicine 

acted upon, "by this mcaus Will likewise be shortened, so that a young man will be 

able to qualify himself to practice physic at as much less expense than 

formerly, as a child would have to read and write by the help of the 

' Roman alphabet, instead of Chinese characters (ibid, pp. 34, 35). 



action of 
purgatives. 



THE DOCTRINE OF PURGATION. 97 

374. The efficacy of this remedy (purgation) in the cure of dropsie:^, 
has been acknowledged by physicians in all ages and countries (vol. II, 
p. 182). Both drastic (md gentle purgatives act by diminishing the ac- 
tion of the arterial system, and thereby promote the ahsorption and 
discharge (ibid. p. 183). 

375. However varied morbid actions may be in their causes^ seats ah diseases 
and effects, they are all of the same nature, and the time will probably (Ipothe^m^) 
come when the whole nomenclature of morbid actions will be absorbed 
in the simple name of " Disease " (ibid., p. 234). 

376. A m^ild remittent, and yellow fever are different grades of the 4,?^*f^5^: 
same disease (ibid., p. 256). auuted yei- 

low f&oer. 

377. If we mean by gout a primary affection of the joints, we have Gout;—& 
gained nothing by assuming that name ; but if we mean by it a disease S Srai 
which consists simply of morhid excitement iwoited hy debility y and dis- mST^this 
posed to invade every part of the body, we conform our ideas to facts, ^^^w ^jmpii- 
and thus sim^plify theory and practice in chronic diseases (ibid., p. 272). and practice 

'^ in chronic 
diseases. 

378. The gout affects most of the viscera. In the hrain it produces ^out, con- 
headache, vertigo, coma, apoplexy and palsy ; in the lungs, pneumonia, ^Jt'j^'JP^^^J' 
notha, asthma, hemoptysis, consumption; in the throat, inflammatory aii diseases 
angina ; in the uterus, hemorrhagia uterina ; in the hidneys, strangury, ^^"""^auLT^ 
diabetes, and calculi ; in the liver, inflammation, suppuration, melea, 
schirrhus, gall-stones and jaundice (ibid., pp. 258, 259). All these dis- 
eases ha/oe hut one cause, and they are exactly the same, however differ- 
ent the stimulus may be from which they are derived (ilDid., p. 261). 

379. Thus rheumatism, the gout, the measles, small-pox, the different Local ageo- 
species of cynanche — all furnish examples of the connection of local ^Inl^r^fdia- 
affections with general diseases ; but the apoplexy and the pneumony ease. 
furnish the most striking analogy of local affections succeeding a general 
disease of the system (ibid., p. 86). 

380. Pneumony is apoplexy of the lungs, allowing only for the dif- pneumowy. 
ference of situation and structure (ibid., p. 87). 

381. After the production of predisposing debility of the system unity of dis- 
from the action of remote causes, thefljuids are determined to the weak- demonSatT-'^ 
est parts of the body. Hence the effusion of serum or blood takes place ed. 

in the lungs. When serum is effused, a pituitous or purulent expectora- 
tion takes place ; when blood is discharged a disease is produced which 
has been called hemoptysis. The pneumony is produced by remote 
exciting causes which act on the whole system (ibid.) . . The expectora- 
tion which terminates the disease in health is always the effect of effu- 
sions produced by a general disease (ibid., pp. 87, 88). 

382. "Who has not seen ih.Q pulmonary symptoms alternately relieved uon-na^txae 
and reproduced by the appearance or cessation of a diarrhoea or pains in J,"^^ IpSr 
the bowels? (Ibid., p. 85.) ^aSl.^'"*'' 

1 



THE DOCTEINE OF PURGATION. 



of disease. 



The re:og- 
nition of this 
doctrine is of 
the 7i ig7i est 
importan ce 
to human- 
ity. 



Experience 
of Dr. Rush, 



383. Science has mucli to deplore from the inaltiplicity of diseases. 
It is as repugnant to truth in medicine as polytheism is to truth in reli- 
gion. The physician who considers every different affection of the dif- 
ferent systems in the body, or every affection of different parts of the 
same system, as distinct diseases, when they arise from one cause, resem- 
bles the Indian or African savage who considers water, dew, ice, frost 
and snow, as distinct essences ; while the physician who considers the 
morbid affections of every part of the body, however diversified they 
may be in their form or degrees, as derived from one canse, resembles 
the philosopher who considers dew, ice, frost and snow, a^ different 
modilications of water, and as derived simply from the absence of heat 
(vol. III., pp. 146, 14Y). 

Humanity has likewise much to deplore from this paganism in medi- 
cine. The sword will probably be sheathed forever as an instrument of 
death before physicians will cease to add to the mortality of mankind 
\)j prescribing for the names of diseases (ibid., p. 147. Account of the 
bilious yellow fever of 1793). 

384. Sow Dr. Hush came to helieve in the efficacy of purgation. — 
Condensed from pp. 222-230, vol. III. : 

I gave gentle purges and vomits, bark in all its usual forms, applied 
blisters to the limbs, neck and head, attempted to rouse the system by 
wrapping the whole body in blankets dipped in warm vinegar (p. 223), 
rubbed the right side with mercurial ointment, with a view of exciting 
the system throughthe liver ; none of these remedies were of any service. 
I returned to bark, wine, and the use of cold water (p. 224). . . Had the 
authority of Dr. Cleghorn for the former, who says : " The bark, by 
bracing the solids, enables them to throw off the excrementitious fluids 
by the proper emunctories," &c. N^o better success, however, attended 
my efforts (p. 225). . . I ransacked my library, and pored over every 
book that treated of yellow fever (p. 226). . . I recollected that I had 
among some old papers a manuscript account of the yellow fever as it 
prevailed in Yirginia in 1741, which had been put into my hands by 
Dr. Franklin, a short time before his death. I now read it a second 
time, and paused upon every sentence. I was struck with the following 
passages (p. 227) : 

385. {Dr. FranTdin^ loquitur): "It must be remarked that this 
evacuation (meaning the purges) is more necessary in this than in most 
other fevers. The abdominal viscera are the parts principally affected 
in this disease, but by this timely evacuation their feculent corruptible 
contents are discharged before they corrupt and produce any ill effects ; 
and their various emunctories and secerning vessels are set open, so as to 
allow a free discharge of their contents, and consequently a security to 
the parts themselves during the course of the disease. By this evacua- 
tion the very minea of the disease, proceeding from the putrid miasmata 
fermenting with the bilious and other humors of the body, is sometimes 
eradicated hy the timely emptying the abdominal viscera, in which it first 
fixes, after which a gentle sweat does, as it were, nip it in the bud " 
(ibid.) 

Pv/rgauon 386. '^ When the primce vice, but especially the stomach, is loaded 

sweoThpte- with an offensive matter, or contracted and convulsed with the irritation 



Fkanklin 

on YELLOW- 
FEVER. 

Purgation in- 
dispensable. 
The abdom- 
inal viscera 
chiefly af- 
fected. 



THE DOCTRINE OF PURGATION. 99 

of its stimulus, there is no procuring a laudable sweat till tliat is re- moving im 
moved ; after which a necessary quantity of sweat breaks out of its own wh?cT** pre 
accord, these parts promoting it, when, by an absterging medicine, they 
are eased of the burden or stimulus which oppresses them" (p. 228). 



vent exuda- 
tion. 



387. " All these acute putrid fevers require some evacuation to bring ah fevers 
them to a perfect crisis and solution, and that even by stools, which must gation. 

be promoted by art, when nature does not do the business herself" 
(ibid.) 

388. " On this account, an ill-timed scrupulousness about the weak- The weaker 
ness of the hody is of had consequence in these circumstances ; for it is the g'JeS 
that which seems chiefly to make evacuations necessary, which nature is ^^rfulipul 
ever attempting, after the humors are fit to be expelled, but is not aation. 
able to accomplish for the most part in this disease. And I can afiirm 

that I have given a purge in this case when the pulse has been so low 
that it could hardly be felt, and the debility extreme, yet both one and 
the other have been restored by it " (pp. 228, 229). 



use- 



389. Here I paused. A new train of ideas suddenly broke in upon weak 
my mind. I supposed that my want of success, in several of the cases fesgf** 
in which I attempted the cure by purging, was owing to the feebleness of 
my purges (ib., p. 230). 

390. By full and continued purgation I cured perfectly four out of Astonishing 
the f/rst five patients^ notwithstanding some of them were advanced sev- fufgaHn— 
eral days in the disease. One gentleman had passed twelve hours with- {J® diad ' rE 
out a pulse, and with a cold sweat on his limbs. His relations had given stored to Ufe. 
him over. Dr. MitchelVs account of the effect of purging in raising the 

pulse excited a hope that he might be ^ved, provided his bowels could 
be opened. Purges were given to him three or four times a day ; at 
length they operated and produced trwo copious fetid stools. His pulse 
rose immediately. A universal moisture on his skin succeeded. In a 
few days he was out of danger, and soon afterwards appeared in the 
streets in good health (p. 232). . . In three days he had taken eighty 
grains of calomel, and rather more than that quantity of rhubarb and 
jalap (ibid.) 



391. This practice could be said to be almost uniformly effectual in caiomeiwith 
all those cases which I wa^ able to attend. . . Many used calomel in opi "' "" 
connection with bark, winl| and laudanum, without any good effects. . . ^^^® 
I can never forget the transport with which Dr. Pennington ran across 



bark or 
um use- 



Dr. Pen- 



Third Street to inform me " that after he began to ^iyq strong purgatives mngtona^nA 
the disease yielded in every case'''' (ibid., p. 235). pSg^f. 



loices. 



392. Never did I experience such sublime joy as I now felt in con- Br.Rushre. 
templating the success of my remedies. It repaid me for ail the toils 
and studies of my life. The reader will not wonder at this joyful state 
of my mind when I add a short extract from my note-book of the 10th 
September : " Thank G-od ! out of one hundred patients, whom I have 
visited or prescribed for, this day, I have lost noneP'' (Ibid., p. 234.) 



100 



THE DOCTRINE OF PTJRGATION. 



All kinds of 

pui^es used ; 

the great ob- 
ject being 

./>■«« stools a 

day. 



393. My practice was, to give a purge every day while the fever con- 
tinued. I used castor-oil, salts, cream of tai'tar, rhubarb. Calomel and 
jalap were often ineifectual, then I added gamboge. The purges seldom 
answered the intention for which they were given unless they produced 
four or live stools a day (ibid., p. 240). . . When piirges were rejected or 
slow in their operation, I always directed opening clysters e^ery two 
hours (ibid., p. 241). 



The advan- 
tages of 

purgation 
stated in 

seven propo- 
sitions. 



394. The effects of purging were as follows : 

1. It raised the pulse when low, and reduced it when it was preter- 
naturally tense or full. 

2. It revived and strengthened the patient. This was evident m 
many cases in the facility with which patients who had staggered to^ a 
close-stool walked back to their bed after a copious evacuation. 

3. It abated the painful symptoms of the fever. 

4. It frequently produced sweating, when given on the first or second 
day of the fever, after the most powerful sudorifics had been given to no 
purpose. 

5. It sometimes checked the vomiting which occurred in the begin- 
ning of the disease, and it always assisted in preventing the more alarm- 
ing occurrence of that symptom about the fourth and fifth day. 

6. Removed obstruction from the lymphatic system. 

7. Discharged the bile through the bowels as soon and fast as it was 
secreted, and prevented, in most cases, yellov/ness of the skin (ibid., p. 
243). 



Sympathy. 



The weakest 
part suffers. 



Xo amount 
of fjurga^ 

tion injuri- 
ous. 
Cures ob- 
tained by- 
very large 



395. One of the laws of sensation is, that certain impressions which 
excite neither sensation nor motion in the part of the body to which they 
are applied, excite both in another part. Thus worms, which are not 
felt in the stomach or bowels, often produce a troublesome sensation 
in the throat. . . In like mannSr the irritants which produce fever, in 
ordinary cases pass through the bloodvessels, and convey their usual 
morbid effects into a remote part of the body, which has been prepared 
to receive them by previous debility (ibid., pp. 60, 61). 

396. It is not an easy thing to affect life, or even subsequent health, 
hy copious or frequent purging. Dr. KirMand (Treatise on Inflamma 
tory Rheumatism, vol. I., p. 407) mentions a remarkable case of a gen- 
tleman who was cured of a rheumatisnh by a purge which gave him 
between forty and fifty stools. This patient " had been previously affected 
by his disease sixteen or eighteen weeks." ^. Mosely not only proves 
the safety, but establishes the efficacy of numerous and copious stools in 
the yellow fever. Dr. Say probably owes his life to three-and-twenty 
stools, procured by a dose of calomel and gamboge, taken by my advice. 
Dr. Bedman was purged until he fainted by a dose of the same medi- 
cine (ibid., pp. 243, 244). 



n^lT^km ^^'^' -^^^ ^^*^ ^^^ suppose that a dozen or twenty stools in a day 

but the'^dia- could endanger Life that has seen a diarrhoeaaojiiimjie for several months, 

Sr causae of attended with fifteen or twent/y stools a da/y, without making even a mate- 

* riiaa.'' 'rial breach in the constituticmj f Hence Dr. Hillary (Diseases of Bar- 



THE DOCTRINE OF PURGATION, 



101 



badoes, p. 212) has justly remarked, that " it rarely or never happens that 
the purging in this disease^ though violent^ takes the patient off^ hut the 
fever and inflammation of the howelsy Dr. Clarh (Diseases in Yoyages 
to the Hot Climates, vol. II., p. 322) in like manner remarks that evacu- 
ations do not destroy life in the dysentery, but the fever, with the emacia- 
tion and mortification which attend and follow the disease (ibid., p. 245). 



398. I have remarked in the history of this fever that it was often 
cured on the first or second day by a copious sweat. It would be absurd 
to suppose that the miasmata which produced the disease were discharged 
in this manner from the body. The sweat seemed to cure the fever only 
hy lessening the quantity of the fluids., and thus gradually removing the 
depression of the system. . , The reason why a few strong purgatives 
cured the disease at its first appearance was, because they abstracted in 
a gradual manner some of the immense portion of stimulus under which 
the arterial system labored, and thus gradually relieved it from its low 
and weakening degrees of depression. . . Bleeding was fatal in these 
cases, probably because it removed this depression in too sudden a man- 
ner (ibid., pp. 277-279). 



Sweats 

(crises) 

and pttrffes. 



Bleeding 
fatal. 



399. BoA^on Humboldt informed me that Dr. Caristo had assured him 
that barh hastened death in every case in which it was given in the yel- 
low fever of Vera Cruz. If, in any instance, it was inoffensive or did 
service in our fever, I suspect it must have acted upon the bowels as a 
purgative. Dr. Sydenham says that barTc cured intermittents hy this 
evacuation., and Wm. Bruce says it operated in the same way when it 
cured the bilious fevers at Massuat (ibid., p. 293). 



Barh 
destructive 
except when 

it acts as 
pm'gatwe. 



400. The result: 

Whilst Dr. Rush was working from eighteen to twenty hours a day, anr^'iauda- 
healing and saving by hundreds, the old-school physicians, who derided °"'"- 
his innovations, persisted in the use of barh, wine, and laudanum, and 
thus succeeded in hilling their patients ''''secundum artem.^^ 

401. The Rev. Mr. Fleming, one of the ministers of the Catholic clerical evt- 
church, carried the purging powders in his pocket, and gave them to his vorS purga- 
poor parishioners with great success. He informed me that he had ad- *^°"* 
vised four of our physicians, whom he had met a day or two before, " to 
renounce the pride of science, and to adopt the new mode of practice, 

for that he had witnessed its good effects in many cases " (ibid., p. 314). 



402. Reason and humanity OAJoahe from their long repose in medi- 
cine, and unite in proclaiming that it is time to tahe the cure of pestilen- 
tial epidemics out of the hands of physicians, and to place it into the 
hands of the people ^ . . The safety of consigning to the people the cure 
of pestilential fevers, especially the yellow fever and the plague, is 
established by the simplicity and uniformity of their causes and of their 
remedies. 

403. Dr. Lind has remarked that a greater proportion of sailors who 
had no physician recovered from the fever than of those who had the 



Reason and 
humanity 

are opposed 
to medical 
monopoly. 



Popular com 
pared with 

medical 
treatment. 



102 



THE DOCTRINE OF PURGATION. 



The worst best iiiedical attendance. The fresh air of the deck of a ship, a purge 

'f coki water, pro" 
cordial juleps of the physician (ibid., p. 319). 



t^y^slSpieS of salt water, and the use of cold water, probably triumphed' over the 

to cm-e 



Other medi- 
cal mo7iopo- 
lies consid- 
ered and 
their h 7/m 
bu{7 de- 
nounced. 



Medicalmo- 
napoly fur- 
ther consid- 
ered. 



Medical ig- 
norance and 
contradic- 
tions. 



tt04:. For a lon^ while air^ water, and even the light of the sun, were 
dealt out hy physicians to their patients with a sparing hand. They 
possessed for several centuries the same monopoly of many artificial 
remedies. But a new order of things is rising in medicine (ibid., p. 
320). It is not more necessary that a patient should be ignorant of the 
medicine he takes, to be cured by it, than the business of government 
should be conducted with secrecy in order to secure obedience t(5 just 
laws. Much less is it necessary that the means of life should be pre- 
scribed in a dead language, or dictated with the solemn pomp of a ne- 
cromancer. The effects of imposture in anything are like the artificial 
health produced by the use of ardent spirits. Its vigor is temporary, 
and is always followed by misery and death (ibid., p. 321). 

405. I would as soon believe that ratafia was intended by the author 
of nature to be the only drink of man, instead of water, as believe that 
the knowledge of what relates to the health and lives of a whole city or 
nation should be confined to one, and that a small and privileged order 
of men. But what have physicians, and what have universities and 
medical societies done, after the labor and studies of so many centuries, 
towards lessening the mortality of pestilential fevers ? They have either 
copied or contradicted each other in all their publications. Plagues and 
malignant fevers are still leagued with war and famine in their ravages 
upon human life (ibid., p. 323 ; cf. Asclepiades, 63). 



406. A Mohammedan and a Jew might as well attempt to worship 
Why Dr. the Suprcmc Bein2f in the same temple, and throusih the medium of the 

Rush would ^ . o . . i? ^ '•, ' '^^ J i.' 

never "con- samc ccremonies, as physicians oi opposite principles and practice at- 
^thVb^k-^ tempt to confer about the life of the same patient. What is done in 
j^^eand^au- conscquencc of such negotiations (for they are not consultations) is the 
ineffectual result of neutralized opinions ; and, wherever they take place, 
should be considered as the effect of a criminal compact between physi- 
cians to assess the property of the patients, by a shameful prostitution 
of the dictates of their consciences. . . 

The extremity of wrong in medicine, as in morals and governments, 
is often a less mischief than that mixture of right and wrong which 
serves, by palliating, to perpetuate the evil (ibid., p. 349). 



Purrje until 



407. In one very malignant case the most drastic purgatives brought 

BLAcrcFETm) away, hy fifty evacuations, nothing but natural stools. Y^q purges were 

conUnued, and finally hlachfmces were discharged, which produced im- 



F^CES — cri- 
sis — come 

fSot*''*^ ^^^^'^^^ r6Z^^(ibid., p. 375) 



408. I observed the same relief from large evacuations of fetid hile in 

This plan the epidemic of 1797 that I have remarked in the fever of 1793. Mr. 

moveadehU' Bvyce has taken notice of the same salutary effects frqm similar evacua- 

^*y'' tions in yellow fever on board the Busbridge Indiaman in 179^. "It 

was observable that the more darh colored and fetid such discharges were 

the more early and certainly did the symptoms disappear. Their good 



THE DOCTRINE OF PUKGATION. . 103 

effects were so instantaneous that I have often seen a man carried upon 
deck, perfectly delirious with subsultus tendinum, and in a state of the 
greatest apparent debility, who, after one or two copious evacuations of 
this hind, has returned of himself, astonished at his newly-acquired 
strength " (Annals of Medicine, p. 123). 

. 409. Very different a/re the effects of tonic remedies when giA)en to re- 
move this apparent dehilii/y. The clown who supposes the crooked ap- whilst toniA 
pearance of a stick, when thrust into a pail of water, to be real, does not TSy. 
err more against the laws of light than that physician errs against 
a law of the animal economy who mistakes the debility which arises 
from oppression for an exhausted state of the system, and attempts to 
remove it by stimulating medicines (vol. lY,, p. 38). 

INTEKESTING ARTICLE. 

Baelow, Edward, M. D., Pathological and Practical Observations. 
Bath, 1810. See Edinb. Med. and Sueg. Journ., 1814, Vol. X. 

410. Purgatives are of three sorts : some evacuating the fecal con- Purgatu^es 
tents of the intestines ; others acting on their exhalent arteries, and pro- V&T'^^lner, 
ducing copious watery stools — and a third class stimulating the mucous fe7y'^°s^toSs] 
follicles which so abundantly line the intestines and causing; them to expeimu- 

T 1 1 . 1 TTTi IT 1 c^'^^ matter, 

expel the mucous matters they so copiously secrete. When the bowels first, in inac- 
are merely inactive, their secretions healthy, and no constitutional disease the''^"bowe°is, 
present, the simple aperients of the first class suffice to obviate costive- co^KiSf • 
ness and prevent feculent accumulations. The second are requisite .second, m 
when, in addition to unloading the intestines, it is desirable to abate tion or\eve?i 
internal action or allay fever, by reducing the quantity of the circulating ^'drcSng^ 
fluid ; and the third are required either when the mucous secretions are f^ ^orwdu ' 
so morbid as to give rise to diseases, or when they are too copiously gen- or super- 



erated in consequence of increased action of the vascular system (pp. of mucous 

431, 432). secretions. 

Brandreth's Pills in one medicine accomplish the three indications required. In doses of 
from one to four Pills, they evacuate the fecal contents of the intestines ; from four to six 
they operate upon the exhalent arteries and produce copious watery stools ; in doses of from 
six to ten pills they stimulate the mucous follicles which so abundantly line the intestines, 
causing stools of pure mucous. In headaches, dyspepsia, apoplectic and paralytic symp- 
toms, and in gout and rheumatism, no cure can be obtained withovit the expulsion of large 
quantities of this mucous, which Brandreth's Pills effect with entire safety, 

411. "When it is considered that the diseases of repletion are by far Diseases of 
the most numerous that the human body is liable to ; that the cMmenta- **p^gSe7 
TV canal affords one of the most important outlets for discharMff the ^,^°°°* ^® 

1 1 i> L^ , ,^ , •, • -\ ••! I' ^.°.T dispensed 

redun Clancy oi the system ; that it is also a principal one tor gettmg rid with to re- 
of the excrementitious impurities, with which in such diseases the hlood "^cJem^ntf-''' 
is speedily adulterated, and that the diseased secretions which accumu- ^'^omThe^'^ 
late within it are oftentimes a means of continuing, of complicating, ^^od, 
and even of creating various diseases in different parts of the body, the 
value of purgatives cannot fail to be duly appreciated. 

It remains for me to show that such f)iorhid secretions do exist within ^orwd se- 
the stomach and intestines, and that they do produce therein the effects cretions in 
now attributed to them, being the direct cause of some local complaints, intStines^"^ 
while they beget also, hy remote sympathies^ diseases in distant parts (p. sympathy. 
432). 



ease. 



104 . THE DOCTRINE OF PURGATION. 

412. Of the existence of superabundant mucous in the stomach and 

^'X'"*' intestines during inflammatory complaints, sufficient proof will be 

oMntfstfnes ^^^rdcd mcrelj by inspecting the discharges brought off by particular 

and stomach, evacuants, or occasioually by the natural efforts. With respect to the 

stomach this examination may mislead, if only superficial ; for the 

mucous being clear and colorless, is not readily distinguishable from the 

watery fluid surrounding it ; if, however, a rod or wire is passed through 

the liquor, and elevated, it will raise the mucous existing therein, and 

sufficiently manifest its dense and viscid nature (p. 433). 

superabun- 4^3 It is this mucous that is produced by increased arterial action, 

dant mucous n^ • ^ iiPii ^ • .itt,' 

creates dis- aiiectmg tlic uiucous giauds ol the stomach m common with all the 

other parts. To it, and to the action which produces it, superseding the 

healthy action of these parts, do I attribute the incipient nausea of fever 

a«=SheIc- ^^^^ ^^ constitutional inflammation ; and its expulsion I deem important, 

tion^ of the both as removlng an injurious accumulation, and as enabling the secret- 

^^SpSg"^ ^^^ vessels, thus disencumbered, to continue those efforts, whose direct 

mucous. tendency is to relieve the general circulation, however inadequate they 

may be, when unassisted, to accomplish this purpose. Similar secretions 

are going forward also at such times throughout the whole course of the 

intestinal canal, and are evidenced by the quantity of mucous which a 

dose of calomel or antimony, administered under such circumstances, 

uniformly expels (ibid). 

Eow to se- 4:14. The want of sufficient attention being given to the peculiar 
^tives^—' ^'^^^^ produced by different purgatives, may perhaps suffice to account 
when the mu- for the Uncertainty and indecision which still prevail in their employ- 
is^'^'of Te^cent mcut. If this mucous niatter is recently formed, and in no great abund- 
dZ^icTmf- aiice, a common purgative of the drastic hind will suffice to remove it, 
J^^; together with all such fecal lodgments as may have taken place in the 

intestines. A source of injurious irritation is thus removed • the various 
secreting and excreting vessels are left free to perform their natural func- 
tions ; and the progress of nature, in her force to restore health, goes for- 
when it is of ward uninterruptedly. If the mucous secretions are of older format/ion 
ti°on, p^er- and Consequently more viscid, more tenacious and more difficultly expelled, 
mes^^^'^' th.e common purgatives fail to give relief, and a doubt is cast on the pro- 
priety of employing them, and on the vera(3ity of previous reports of 
successful cures. The error here, however, is in employing a piirgative 
Salts ineffec- inadequate to producing the effect required. ... If saline purgatives 
tuai ^-^Q giv^ with the expectation of cleansing the intestines when loaded 
with mucous secretions, they will very imperfectly effect this purpose 
(pp. 433, 434). 

Large quan- 41^5^ ^j^g quantity of this mucous secreted in acute diseases is very 

titles of mu- .TiiTTiii 1 !• • T '^ 

cous from considerable. It lines both the stomach and intestines, and causes many 

eases binder powcrful mcdicincs to pass through them without producing: their ordi- 

of many^pur° nary cffccts ; for, in consequence of the interposed mucous, the medicines 

gatives. Gomc Only imperfectly or not at all in contact with the living fibre, which 

alone they are capable of stimulating. It passes through, therefore, as 

if either the living fibre were torpid, or the medicine inert, when neither 

supposition is correct^ and to mistake and accident we are occasionally 



THE DOCTRINE OF PURGATION. 105 

indebted for illustration of this subject, which perhaps regular prac- 
tice would more slow^ly and imperfectly afford us. For the errors of ^oftTn w* 
dispensers and the stupidity of patients have not unfrequently afforded 
me instances of inordinate doses of purgaUve medicines being given, "^^^rt, 
with only moderate and salutary operation (p. 434). 



h'ut moder- 
ate opera- 



416. Case of scarlatina given. — Purgatives were, in consequence, s^riauna. 
thenceforward more freely employed, and the effect regarded more thorn, and^ not^the 
the dose necessary for producing it ; and although the inflammatory ^oSderei 
fever ran high, and was not allayed for many days, there did not occur 

a speck of ulceration on either tonsil. Neither did any of the ordinary 
sequelae attend the disease, but the recovery was progressive and com- 
plete. 

We may hence infer the difficulty of establishing the precise doses 
of medicines to be admitted, and must be conscious of the superior ad- 
vantage of attending solely to the sensible operation^ when this is capable 
of being ascertained, disregarding altogether the quantity of medAcine 
necessary for effecting it. This is always possible with respect to purga- 
tive medicines, and to be accomplished by regular inspection of the alvme inspection 
evacuations^ without which the practitioner must remain in much doubt '^iaUonTx^Q- 
concerning some of the mobt important operations going forward within ommended. 
the body, and must labor under great disadvantages in accurately apply- 
ing the remedies it is necessary to employ (p. 435). 

417. Morbid secretions are very frequently formed in the stom- MorWd mat- 
ach, which occasion a large proportion of gastrric diseases. To par- stomach oc- 
ticularize only one. Conceiving the pain in gastrodynia to proceed '^'^^tHc au-^' 
from a contractile effort of the stomach to throw off from its surface the Aa^H' . 
mucous which offends it, I have for many years laid aside the use of dynAa. 
opium and stimulants., which merely repress the effect, without at all re- 
m.oving the cause, and which even tend to add to this by stimulating the ^§J3aS? 
glands to increased secretion of the offending mucous, and have trusted ^^ ^^ot re- 
solely to such medicines as act hy expelling that matter, to whose presence c^J—pur- 
I attribute the complaint. . . ^ ^^dlhe"''' 

I own I am averse to relieving the pain by opium, or by any means ^'^Ste?^ 
but a removal of the offending matter — as the relief to pain consequent 
upon such evacuation may be relied on as announcing the radical cure of 
the complaint. In some hundred cases that I have now treated on these 
principles I have in no instance given a grain of opium, or failed in 
giving decided relief Almost the only medicine I employ as a purga- 
tive compound consists of extract of colocynth, calomel, and antimonial 
powder (p. 436). 



418. The disease of colic I believe to \>e precisely analogous with gas- coii<^ns 
trodynia, both in its pathology and treatment, and to differ only in being treatment, 
more prone to pass into inflammation. The remote sympathies which 
different parts of the body evince under disordered condition of the 
stomach and digestive organs have often engaged the attention of prac- 
titioners (p. 43Y). 

419. I have mentioned that in all complaints attended with fever, or conZutl'i^ 
constitutional inflammation, the gastric and intestine secretions are ^^i^^"^ 



IOC THE DOCTEINE OF PURGATION. 

quickly increased. Accumulations of morbid secretions oftentimes take 
ci4^timS'^and pkicc in tlic alimentary canal, of slow and gradual formation, and not 
increased ar- referable by any well-marked connection to a state of generally increased 

tenal action. , • i /• "^ mi x» j. i. i °- i i . i 

arterial action, ilie former state may even be superinduced upon the 
latter, and thus an additional complication, both of diseased action and 
of diseased condition, ensue. A disease, in which this morbid state of 
the secretions exerts considerable influence, is rheumatism (ibid.) Cases 

Rheuma- j> ^ ^ ^ . 

tism. ' lOllOW : 

Gout. 420. Admitting, then, the pathology to be correct which attributes 

cure^by' gout to the existcucc of a state of plethora and inflammation in the Mood- 

■pnrgatives. q^^gg^ig^ ^iid the influence of vitiated secretions within the alimentary 
canal — which latter may be regarded in a great degree as the natural 
product of the former — does it not seem to be fully w^ithin our power to 
bring this hitherto intractable disease under the control of rational prac- 
tice ? And may we not hope to treat it as eflectually, and much more 
safely, by the well-ascertained powers of such a remedy as a combina- 
tion of colocynth, calomel, and antimony presents us with, as by the less 
manageable means of white hellebore, or the precarious and uncertain 

CoicMoum. u g^^ medicinale," i. e.. " colchicum f^ (P. 441.) 

AppUcabieto 421. The means I would recommend are advocated not for their 
^^'^Piiif^'^ possessing any secret or unexplained power ov^r disease, but from their 
\,^\x\^^ jpointed out hya rational pathology, and fully established, both with 
respect to their safety and efficacy, hy extensive experience (ibid.) 

B. G. B., Observations on the Treatment of the Sich returned from 
Corunna. See Edinb. Med. and Sueg. Jotjen., 1810, Vol. VI. 



jFevers. '^^2. There appears too great a desire of discovering something like 

c.domei— ^ specific for fever to the very great neglect of obtaining evacuations. 

persede pur- Galomcl sccms to be regarded in this way, and is abundantly employed 

cuiei— soie^- with a vicw of producing some particular irritation of the system that 

asa^zSva- ^^ arrest the progress of or remove the complaint. 

tvoe. Whatever this medicine may do, after evacuations have been prom- 

ised, I feel certain of one thing, that it will never supersede the neces- 
sity of evacuations in fever ; and I question very much if its good effects 
in fever, and in all inflammatory complaints, do not depend upon its 
evacuating qualities (p. 170); 

Br. Freind ^2^- Those, howevcr, who attempt to cure inflammatory fever, or in- 
^on f^e^e^^^— flammation, by any other means than by evacuation of some sort or other, 
''alone can will losc many an opportunity for doing good / and, in. confirmation of 
*^VthS^' this opinion, 1 will quote the authority of the very learned Dr. Freind: 
^' Hoc unum libi spondeo te experiundo comprobaturum, quod silicet ex 
febribus multse evacuantibus solis, etiam si hand alio fueris remedio 
usus, cedere consuescant ; vix ullse antem, quae paulo vehementius in- 
valuerint, medicina qualicunque, si ab hoc evacuandi instituto decesseris, 
restingui possint." (Commentaries on 1st and 3d books Hippocrates.) 
Dr. Freind here observes that many fevers will yield to evacuations 
alone, when no other remedy is used j biot scarcely any will be removed^ 



death. 



THE DOCTRINE OF PURGATION. 107 

when the fever is great, hy any remedy whatever, if evacuations are not 
employed. I have no hesitation in saying, when this plan is speedily 
adopted, that the most beneficial effects will generally result, and that 
a great many cases of inflamm.atory fever which would otherwise have 
ended fatally, or become putrid, and have been protracted for a fort- 
night or three weeks, or even longer, will hy this system terminate favo7-- 
ably in a weeh (pp. ITO, 171). 

TuoMEY, Martin, M. D., A Treatise on the Principal Diseases of Dub- 
lin. Duhlin^ 1810. 

424. Bilious fever. — Purgatives must he steadily persevered in ismmsfe' 
throughout the complaint, for it is upon them we must chiefly rely for ver. 
success ; and as tlie acoumidation of foul matters in the alimentary canal 
is constantly and copiously produced, so there is no disease in which the 
free and regular use of purgatives causes less distress or gives more uni- 
form relief. It frequently happens that from the operation of a purga- copious 
tive a large quantity of foul excrements come away ; and yet in ten or evatu/uoL 
twelve hours after there is another large evacuation, so as often to cause ^^Shhxxt 
■just surprise how so much could be venerated in so short a time : and induce 
these copious and loul evacuations continue tor several successive days 
without inducin^^roportionate weakness, but, on the contrary, they 
procure great mffl^ation of the symptoms. Even delicate and young 
females are relieved, without heing exhausted, by these evacuations (p. 8). 



no 

weakness. 



E'vaouO' 



425. So far from producing weakness, we have often observed with j^^aoua- 
pleasure the renewal of strength, which these evacuations occasion, when nons give 
a languor or depression of the animal powers, even to faintness, had pre- remove de- 
viously existed. But we have likewise remarked that, as soon as the ^^^^*^' 
alvine excretions have assumed a natural appearance, a much smaller 
evacuation has actually produced a considerable reduction of strength 

(p. 9). 

426. It is remarkable that we are disappointed of any substantial ^^jj^p^^gg 
improvement in the state of our patient whilst the darhfceces remain are critical. 
behind, notwithstanding the quantity of the evacuations procured (ibid). 

BucHAN, A. P., M. D., Bisnomia. London^ 1811. 



427. Is it credible that a human infant should be so imperfectly or- chudhood 
ganized that it cannot pass over the years of childhood, naturally the c(aomei. 
most healthy period of life, except the biliary system be ever and anon 
expurgated by calomel ? or that the early and habitual use of this min- 
eral poison can be unattended with injurious consequences? Perhaps 
the time may come, when the most judicious plan of curing internal as timeto^come 
well as external complaints,will be acknowledged to consist in removing 
all impediments to the natural exertions made by the vital energy to re- 
store health (p. 71). 



108 



THE DOGTRINE OF PURGATION. 



Clark, Joseph, M. D., On the JBilious Colic and Convulsions of Early 
Infancy. Diiblin^ 1811. See Transactions of the Eoyal Irish 
Academy, 1811, Vol. XL 



Childhoorl— 

Loiivulsions 

—the old 



1:28. In the beginning of my practice, as long as I pursned tlie beaten 
track of emplo^^ing mixtures of rhubarb and magnesia, solution of man- 
^pRQlSra ^^''^ ^^^ fennel-water, chalk, musk, opium, and blisters, recovery from con- 
thecure/ vulsions iu early infancy was a rare occurrence. After six years' close 
attention to the subject I am convinced that in colic and convulsions 
nothing but a hrisk expidsion of the contents of the howels is likely to 
afford permanent relief. A dose or two of castor-oil, or a common pur- 
gative enema, may remove slight attacks of this nature. It is in general 
after the failure of such measures that a physician's advice is required 
(p. 124). 



Evacua- 
tions — as the 
quantity so 
is the relief. 



4:29. The purgation must he very active and continuous to be efficient. 
In the course of recovery the quantity of evacuation seldom fails to as- 
tonish the attendants, who cannot well comprehend whence it all can be 
derived. The relief obtained is uniformly proportioned to the quantity 
discharged (ibid.) 



Typhus. — 
Many of its 

symptoms 
from wanting 

iecnrboni- 
zaUon of the, 
Mood. 



Intermittent 

or remittent 

form — 

causes of. 



Armstrong, John, M. D. Observations on the Origin^ Nature and 
Treatment of Tyvhus Fever — m Medical Intelpgencer, 1812. 

430. The want of due decarbonization of the blood is the cause of 
many of the most remarkable symptoms attendant on typhus. Blood 
not duly decarbonized, operates more or less as a narcotic on the brain, 
and tends materially to influence the animal heat and the heart's action ; 
and hence partly arise the muddled state of the brain, the smothered heat 
of the surface, and the soft, compressible pulse, &c. Why typhus-fever 
assumes in one person an intermittent, and in another the remittent or 
continued form, is most probably owing^ to the dose of the poison, or^the 
condition of the recipient, or both conjoined (Med. Int., ]S"o. 30, May, 
1812).* 



The Morbid Anatomy of the Bowels, Liver and Stomach. 



London, 1828. 



Small-pox, 431. The contagions of small-pox, measles and scarlatina first ope- 

sTariitina rate OH the blood, and that fluid being thereby changed, the solids are 

■" ^Ifsts^^^' specifically affected, especially the skin and mucous membranes of the 

air-passages ; and these affections, too, if left to themselves, and even 

Nature com- oftcH in dcspitc of mcdical applications, have a determinate course, the 

tidarflowing blood appoMrenthj , like the water of the Thames, requiring a certain time 

river, y^^ ^-f^g purification, which it effects, perhaps, by throwing off the efete and 

superfluous matters, through the secretions and excretions (Art. 1, p. 10). 

Letter to Dr. Boot, contained in Dr. Booths edition of Armstrong'^ s Worhs. 

Much learn- 432. I havc Hcvcr yet met with a lea/rned physician who was a good 
foilyfn^praS i^^*^^^*<^^^^' -^^ ^^^ bcdslde such mcu are "lost in the conflict of au- 

tical matters, thoritv. 



THE DOCTRINE OF PURGATION. 



109 



Hartz, "William, M. D. On the use of Purgatives in Purpu/ra. 
PuUin^ 1813. See Edinb. Sueg. and Med. Journ., Vol. IX. 



433. Purpura. — Convinced by my previous ill success of tne ineffi- 
cacy of mere tonics in bad cases, and favorably impressed by the occur- 
rence of cholera previous to the appearance of the petechige, I determined 
in this case to direct my whole attention to the state of the abdominal 
viscera, and accordingly prescribed hrish purgatives. From the good 
effects of the first, I directed its repetition for a few successive nights. 
To my surprise the hemorrhage soon ceased, the spots rapidly disap- 
peared, and in less than ten days the patient recovered, under every 
possible disadvantage of constitution, of air, and of diet. Encouraged, 
by the unexpected'result of this unpromising case, I no longer hesitated 
in employing purgatives., and trusting to them only in both species of the 
complaint. It was often necessary, however, to purge to a great extent 
(p. 186). 



Purpura — 
the regular 
practice un- 
successful — 
purgation 

cures. 

Important 

case. 



Full and free 
purgation re- 
quired. 



434. It appears from the observations of Purserius, that Strach ^w^- 
^o^Q^ peteohicB to originateyrwTi vitiated hile in theprimm vice, and from 
a tenacious mucus adhering to the intestines, and that he accordingly 
proposed strong cathartics as the proper remedy for the disease. I have 
carried this theory farther, and have, not without advantage, allowed it 
to influence my practice in typhus^ when petechise are present, and many 
very desperate cases have appeared to me to owe their recovery^ almost 



from the jaws of death^ to 
purgatives (p. 187). 



Typhus. 

Petechiae 

from vitiated 

bile. 



the powerful and repeated interposition of 



Medicus. 
Vol. XL 



On Pathology. — See EomB. Med. & Surg. Jour. 1815. 



435. Disordered actions of the human body are, generally speaking, 
the means which nature employs for the expulsion or removal of offend- 
ing agents ; thus if the stomach be excited to vomit^ the cause producing 
that disturbance is removed by that action ; thus also diarrhoeas carry 
off noxious matters ; and the emunctories of the body are generally 
cleared out for the same purpose (p. 335). As a machine, the human 
body may be said to '' go," at the same time that it includes powers 
for repairing all injuries that otherwise would prevent its going, and 
these reparatory processes include almost all the symptoms of disease 
(p. 336). 



Natural 
cure, by vom- 
iting, diar- 
rhoea, etc. 



436. We will suppose, for example, that the stomach, unable to per- 
form healthy digestion, presents to the liver, as it passes to the duodenmn, 
an ill-concocted chyme or chyle. Does it not become necessary that the 
liver should pour forth a bile suited to the purpose it has to answer ? — 
a purpose far different from what would be required if a healthful 
digestion had taken place in the stomach. Such a bile cannot be deemed 
improper, since it answers the purpose for which it was intended, name- 
ly, of carrying through the bowels what was noxious, and of effectually 



The stomach 

— vicarious 

function of 

the liver. 



no THE DOCTRINE OF PURGATION. 

assisting in assimilating such parts as are healtliy and proper. To attack 

tlie liver, therefore, because it lias done its dntj, would be adding to the 

jfistai-es of evils whicli already excited its powers, and would be exliausting those 

practice — ,, . , ^ -, ^ .^ i • i • , t /> i" 

checking the meaus 01 rcsistauce and reaction which were appointed for the most 
fuiKUorp?o- beneiicent of purposes. To oblige, by medicine, the stomach to retain 
^cl^mpjaint' such sicbstances as, \\\ a state undisturbed by medicine, it would reject, 
is the readiest conceivable method of calling forth the symptoms of " liver 
affection^^ and a general disturha/nce of the alimentary functions. And 
thus it happens that the more extended reactions of the constitution follow 
these circumstances, and thus, by a very easy process of reasoning, shall 
we arrive at those causes which produce gout, asthma, cutaneous diseases, 
and in short a long train ^f grievous maladies (p. 336.) 



437. During healthful digestion, feelings are excited far different 

from those which arise when the meal has not been regulated by mode- 

Teltorr^ ration and sobriety ; and how often are means applied to appease the 

^^ge^Ln.^" tumult occasioned at such times, and thus so many noxious agents are 

introduced, which become all the causes of great and extended future 

mischief (p. 337). 

4:38. It has been said that foulness of the bowels is a common cause 

a^llwds— of disease. It appears to me that when the bowels produce the foulness, 

curative. g^ often obscrvcd, such foulness proves curative. It is a reaction of the 

liver (?) against a constitutional disturbance, which in the end proves 

curative. Immediately on discovering this foulness, we feel satisfied that 

on its removal the various symptoms of disease will disappear (p. 339). 

439. There is a balance in the constitution consistent with every nat- 
tending to^ ural cffort ; it may be called the diathesis, such as gout, and a variety of 
bhrcoStu- other inflammatory affections, and these states of balance involve their 
ion. own series of phenomena. Thus the head may be oppressed with a super- 

abundance of blood, and may be liable to affections under one form or 
series ; another may involve rheumatism ; another, gout, &c. ; and all of 
them, extended reactions of the system, tending towards a reparation of 
the constitution. 

It may be observed that foulness of the bowels cannot exist to the 
full extent at which it appears at any one period ; for the quantity that 
on some occasions is discharged would be more than the canal was capa- 
ble of containing. It must, therefore, be the result of successive deposi- 
tions from some great secreting organs. For instance, during the exist- 
ence of disease, wherein there are great determinations of blood, ape- 
rient medicines bring away evacuations of no particular character ; but 
after a, little time the circwmstances of the case alter / heavy, lumpy, and 
discolored evacuations begin to appear, and contin ue to be parted with. 
As soon as these appearances arise, the symptoms of the original disorder 
begin to diminish, and^ in the course of a short time, disappear altogether. 
It must have occurred to every practitioner who has strictly examined 
these circumstances, that he has found a difficulty in accounting for the 
quality and extent of this collection of foulness (p. 339). 



THE BOCTEINE OF PURGATION. Ill 

440. It must also have been frequently observed that affections of fe?id\tai 
the head, epilepsy, chorea, local diseases of various kinds, and great and break^be 
extended affections of the slcin, have all given way as soon as the howels power of dis- 
have expelled a qicantity of foul and fetid evacuation. During the ^duc^reSc-" 
progress, however, of these maladies, the bowels have not shown the same *'*'°^* 
character until the disorders have attained a particular stage, and then 

the progress towards health is decided. Could we succeed in bringing 
about this stage, many very grievous maladies might be cured ; that is, 
we might induce thereby the various organs of the alimentary canal to 
render the more extended reaction of the system unnecessary. I do not 
mean to deny that there is occasionally a very great accumulation in the 
howels, so foul a state of them that worms occur, which appear there to worms. 
have found a proper nidus ; and that other great sympathetic affections 
take place arising from these accumulations (ibid). 

441. If we trace these affections, we shall find many natural efforts r^^^ natural 
made to remove such accumulations and foulness ; and even that many ^"^^7^^^^: 
very distant reactions occur tending to relieve the body of the griev- tion. 
ance. Thus the hlood returning through the " vena portce,^^ is delayed, 

and as the heart acts uniformly, more blood flows to the head than usu- ^ts coS^r 
ally, in consequence of tTiis remora in the return of blood from the 
lower circulation. This fullness of blood in the head occasions many 
reactions, amongst which we may rank epilepsy, which shakes the whole EpUepsy. 
body in convulsions, and is the means of removing worms and other foul- 
ness from the bowels, as under the influence of that disorder the alvine 
and urinary excretioi* are violently expelled (pp. 338, 339). 

442. Why disease and cure are units, physiologically accounted for. f^*/"^^^f 
— The tendency of disease is either to spontaneous cure or to the exlAnc- 

tion of life (p. 340). 

443. The human stomach is an organ endowed by nature with the ^^'JfJJgf'^ 
most complex properties of any in the body, and forming a centre of mate relation 
sympathy between our corporal and mental parts of more exquisite wh^\e body. 
qualifications than even the brain itself. Yet the knife and eye of the 
anatomist do not discover the whole importance of the station it holds Sympathy 
m the economy. W e must look to the livmg system lor those nice con- through 
nections of cause and effect, and that source of association which gives o^rgans^suffer 
it a relation to so many organs, both in the healthy and disordered state, one^'^may ^be 
.... We find all those viscera which assist in preparing the chyle and the saved. 
assimilation of food, joined in a circle of nervous communication of 

which the stomach is the centre. One portion of nerves is distributed 
over the whole, so that, while they are employed in one purpose, disor- 
der cannot take place in any one of them without the whole being 
thrown into confusion. These associated organs are regulated in their 
apparently disturbed state by laws tending to the relief of that pertur- 
bation. By these associated powers the causes of perturbation are 
removed, and the effects of such reaction are eventually rendered harm- 
less. (Condensed from pp. 345 to ult.) 

444. The nerves of the stomach are connected, through the great sy m- i.ungs, heart, 
pathetic nerve, with almost every other nerve in the hody. The lungs, nt^wm^'U- 



112 



THE DOCTRINE OF PURGATION. 



lation tcith 
the stomach, 
and act with 
it in the "cm- 
rative pro- 
cess" which 
is removal of 
noxious and 

offending 
agents. 



heart, and diaphragm, are also furnished with nerves which communi- 
cate with the great sympathetic. This nerve is the grand link or chain 
which connects the vital, animal, and natnral fnnctions with each other. 
It is no very difficult matted' to trace the curative actions that take place 
in consequence of this nervous cowaection — how the heart may vary its 
pnlsations agreeably to the impulse it receives through this nerve ; how 
the liver and intestines are apprised of the necessity of varied exertions, 
agreeably to the kind of digestion that is to pass the sphere of their du- 
ties, &c. ; all, I say, for the beneficent purpose of ultimately removing 
from the system the noxious influence of offending agents, such influ- 
ence as, were it not for those wise provisions of nature, would prove 
destructive to the human frame (ibid). 



More of this 
" curative 
process." 
If the stom- 
ach is unfit 
to effect this 
cure, excite 
with purgO' 
lives. 



445. These several reactions of the body seem all calculated to 
become efiectual, when the system is in a state agreeable to the laws 
of nature. A really curative process may be so far altered in its ulti- 
mate results I>y improper habits of life^ that it may not be enabled to 
answer the purpose intended, or it may run into an excess, and even 
occasion detriment to the subject (ibid). 



The " cura- 
tive process" 

— conclu- 
sion. 



446. We now see why the operations of the stomach, liver, and 
bowels are so effectual in removing very great and extended disorders 
of the system; and ^^hy, when required, such medicines as call forth 
these reactions of the stomach andprimm vice, are the true means of cure. 
So that, whether a disorder originates in the stom%ph, proceeds to distant 
organs through the stomach, or is a disease arising primarily in a distant 
part of the frame — still such reaictions are capable of anording relief 
(ibid., p. 345, sq., cf.). 

Peitchaiid, J. C, M. D. Remarlis on the Treatment of Epilepsy a/ad 
some other Nervous Diseases. Bee Med. and Phys. Jouen., 1815, 
Vol. XL 



Nerioous 
ddseases — 
cure by pur- 
gatives. 



Epilepsy. 



Neurosis. 



Mania. 



44Y. I consider the introduction of the free use of evacuating reme- 
dies into the treatment of nervous diseases as one of the greatest im- 
provements of the medical art which has taken place of late years. 
Imperfect as our knowledge confessedly is with respect to the pathology 
of nervous diseases, and inadequate as our remedies frequently prove 
themselves to be, we have yet the satisfaction of perceiving that we are 
evidently in the right path ; and that, when we have not the means of 
cure in our power, we can at least often palliate^ without incurring the 
risk of making raatters vjorse than we found them (p. 459). — Cases of 
cures of epilepsy given. 



448. I have tried the use of evacuant remedies in several other dis- 
orders of the class neurosis with success / but in none with more singu- 
lar advantage than in mania., in which distemper I have had extensive 
opportunities of witnessing their effects, having been for some years one 
of the physicians to a hospital where a great number of lunatics were 
admitted. I am firmly persuaded that if medical practitioners would 
depend more on pfuysical and less on moral remedies^ they would succeed 



THE DOCTRINE OF PURGATION. 113 

in a greater proportion of cases, especially recent ojies, than generally 
happens (p. 456). 

449. Indications to be obtained by the use of purgatives are : 

1. By removing sordes from the intestinal canal. JndicaUona 

I am every day surprised at the prodigious accumulation of ^ C^"' 
fecal matters which I find to take place in the intestinal canals 
of patients of all years. 

2. As depleting the system. 

3. As determining the fluids from the head. 

4. As setting up a new action in the system. 

5. Purging is a powerful means of sPimulating the absorbent sys- 

tem, as we witness its effects on dropsical patients. 

6. A course of moderate purgation is one of the most efficient 

methods of invigorating the digestive organs, improving appe- 
tite, and removing visceral obstructions (p. 466). 

Dickson, D. J. H., M. D., Superintending Physician to the Russian 
Fleet. On the Utility of Depletion in a Fever among the Russian 
Sailors. See Edinb. Med. and. Surg. Journ., 1816, Vol. XII. 

450. It is now well understood that the value of purgatives is not p-argames 
limited to the mere removal of the fecal contents of the bowels, but that i^umuJd. "^^ 
they may be so managed as to obviate or relieve a tendency to topical 
congestions elsewhere, and also to produce a considerable effect upon the 
general system^ by the increased quantity of fluids they cause the various Action on 
glands and exhalent arteries to pour into the intestines. Thus they be- f^hauntar- 
come more universally useful in diseases in general, in proportion as ^^^*^*- 
they are more uniformly applicable. ... They were here considered 

not only indispensably requisite in the flrst instance, and assisted by 
enemas, when necessary ; but they were liberally exhibited throughout 
the disease ; and very often the bowels could not be kept sufficiently 
active unless they were repeated day after day (p. 175). 

461. Though not a new, it is a very important observation, that all inspect m 
uncertainty as to their full operation can only be removed by inspection, evacuation 
without which the practitioner is very apt to be led to imagine by the . exact miffi- 
patient from his own report, or that of. the nurse, that he has been suffi- gation^^^' 
ciently purged, when, at most, he may have had only two or three par- 
tial scanty dejections. . . While we are producing foul, dark, fetid 
evacuations, we may naturally expect that we are benefiting and relieving 
the patient By those that have not had much acquaintance with fevers 
it is hardly possible to calculate the quantity of medicine sometimes re- 
quired to overcome the torpor of the %ntestinal canal, the morbid accumu- 
lations that have been discha/rged after repeated purga-^ons, and in some 
cases the speediness of their reproduction (p. 1Y5). 

452. In tropical fevers especially, I have seen very striking exam- Tropical 
pies of the abatement of fever and delirium after the operation of pur- ^^ ' 
gatives, and it is therefore of great consequence to be aware that the 
febrile symptoms are often maintained or renewed by the retention of 



114 



THE DOCTRINE OF PTIKGA^PION. 



Put'fftS 

ynu<<t ht con- 
tinurd until 

until ral 
stools ensue. 



ritiah'd ts\'(VV^//(>//.v, or other morhid contents of the intestines, as also of 
the quantity of dark-colored offensive matter that is often discharged 
after the patient hasheoi thougJit stiff ciently purged, and its speedy ac- 
cumulation in some cases, in order to estimate the extent to which it may 
be necessary to versistin the use of eiimuations (p. 176). 



!Naval Sueoeon. Medical Topography of New Orleans-^ with an 
account of the principal diseases that affected our Fleet and Army 
on the last Expedition against that City. See Edinb. Med. & Surg. 
JouRN., 1816, Vol. XIL 



Dysentery — 

its origin 

from the 

liter. 

Morbid mat- 
ters the 
cause which 
must be re- 
moved. They 

injure the 
fabric of the 

passages — 
cause jiux^ 
ulcerations, 
etc. 



453. Dysentery. — In short, to give a condensed view of the whole 
matter, the phenomena of the cases that recovered, as well as the mor- 
bid appearances of those that died, impressed upon my mind a convic- 
tion that the diseased condition of the liver was the soil from which 
dysentery drew its 'malignant growth, strength, and mcrture. This was 
the " fons et origo mali," by it the dysentery was excited, and only hy 
its removal could the disease he removed. 1 can readily conceive that 
from the disease of any gland, the fluid it secretes may acquire acrimo- 
nious properties sufficient to injure the fabric of the passages through 
which it is destined to pass. 

"We generally observe in dyspeptic complaints, or after a period of 
constipation, when the bile, from remora in the bowels, becomes morbid 
in quantity or quality, either that spontaneous diarrhoea comes on, or, 
after a brisk cathartic has been exhibited, that the dislodged bile excites 
a sensation in the rectum, as if boiling lead were voided. When the 
state of the liver is still more morbid, may not the bile acquire the 
property of exciting fmx, and of excoriating a/nd ulcerati/ng the villous 
coat of the colon and rectum f (Pp. 142, 143.) 



Typhus and 
the bugbear 
'■'' debit ty .'■'' 
Calomel and 
James' pow- 
der. 



Neglect of 
evacuation, 
— its conse- 
quence in ty- 
phus. 

Bark, wine, 
opium. 



454. The imaginations of professional men in tropical climates were 
formerly held in subjection by that bugbear, debility, and its train of 
needless horrors. Systems of nosology had been pleased to style the dis- 
order " typhus icterodes / " consequjently active depletion was carefully 
shunned. The practitioner stood fidgeting with his calomel and his 
James' powder. The disease toolc its hue from the species of treatment 
employed at first. The neglect of evacuation allowed the excitement 
to riot and revel unchecked; hence ch-me petechim, hemorrhages, &c. . . 
Then indeed the disease was pronounced " malignant, pestilent, and 
highly putrescents^ and the golden opportunity occurred for throwing 
in — as the phase is — his bark, his wine, and his opium against that de- 
bility, about which at a wrong time he was over-solicitous. That caba- 
listical word " typhus,^^ I verily believe, has slain its thousands and its 
tens of thousands (pp. 147, 148). 

Dropes, Richard L., Surg., RemarTcs on some Remedies which are Used 



in 



Fevers. jLondon, 1817. See Edinb. Med. and Surg. Journ., 



1817, Vol. XIIL 



Fevers.— 455. Fevers. — Fmetics, I am convinced from experience, have most 

fUaphl^et- frequently proved injurious, and have seldom failed to aggravate the 
ics,a.ndpur- symptoms in a very obvious manner. The great concussion they give 



THE DOCTRINE OF PURGATION. 115 

the whole systern^ particularly the hrain^ almost invariably increased the ^if^^'*^^^' 
violent pain so often felt in the head, and especially over the eyeballs; tuksuprem- 
and this, it is to be presumed, by increasing the morbid action of the latter main- 
vessels of the encephalon. The only cases in which emetics are admissi- Jjoved. ^°'' 
hie are those in which an obstinate vomiting takes place, owing to some 
crudities in the stomach, which require to be evacuated (p. 59). 

456. Diaphoretics. — I believe that it is on the principle of the heat sudorifica 
of the body being morbidly increased, owing to obstructed perspiration, JfoXand^b^y 
that sudorifics are prescribed for the purpose of removing this obstruc- "^^'^^^^orfh 
tion, and lowering the temperature. However, I conceive this practice a cure. 

is not well founded. Diaphoretics^ before they can have the desired 
effect, almost always increase the marhid act/ion^ and most ohviously Jiawe 
an injurious tendency. Besides, we have other means of lessening vas- 
cular action and reducing morbid heat without being attended with the 
same inconvenience as sudorifics. Every day we see patients attacked 
with fever completely recover without there being the smallest tendency 
to a diaphoresis through its wliole course. When these medicines have 
heen chiefly relied on^ J have always observed the disease to he much pro- 
tracted^ and the cure extremely tedious (p. 60). 

457. Purgatmes. — The generality of physicians place too little de- t^^o'Sf reu- 
pendence on these., and trust too much to other remedies. I know of no ^^^^^^^f^n 
general means attended with so much success as the liberal employment in large 
of catha/rtics. They should be given in large doses, and often refeated, replatecu^*^" 
till the patient hecomes convalescent, which is generally in a few days 

from their first employment (ibid.) 



458. When given merely as aperients their effects are only trifling; Aperient and 
but when administered with sufficient freedom, with a determination of f?ii p"fP 

,1 ."^ i. ' /,, J. ' -L ' ti^e action 

REDUCING- INFLAMMATION, ttieir curativc powcrs are often astomsmng contrasted. 

Wilson, Andrew, M. D., Practical Observations on the Action %f Mor- 
bid Sympathies. Edinburgh, 1818. 

♦ 

459. IS'erves possess muscular fibers and blood-vessels, and are subject mrvous 
to foreign influences ; and the condition of the blood must injhuence their from impure 
actions by influencing their secretion (text condensed from pp. 20, 21, 
and 82). 



blood. 



460. There is no department of the nervous system by which, if cer- Sympathy 
tain or peculiar irritating causes are applied, some other department of ° 
the same system may not be influenced, so as to draw the organ to which 
they belong into morbid action by sympathetic afiinity (pp. 165, 166). 



MorMd 
matters in 



461. Certain acrimomous matters applied to the extremities of the 
gastric and aVvine nerves give a variety of deranged actions of the brain, the stoniach 
although otherwise in a sound state, and the accelerated pulse of the de?s of ^°the 
whole arterial system, from inflammation found in a small portion of its 
capillary branches, is at once perceptible both to the eye and touch. . . 



brain, strict- 
ures, etc. 



lie THE DOCTRINE 01^' PURGATION. 

Gastric f'rritafio/i gives sjmsmodic affections of the lladder and Md- 
neys. . . Irritation "of tlie lower extremities will excite nausea and vom- 
iting (pp. 166, 167). 

The body a -162. Of all tlie organs of tlie human body the gastric and alvine de- 

bid ''mJmlre pjii'tment is that whicfi is most extensively and constantly exposed to the 

derange any actiou of thesc causes ; a surface which extends from the cardia to the 

pt?t o7^the rectum, every part of which is provided with nerves of the greatest sen- 

^^'^- sibility (pp. 167, 168). 



causes. 



Fever— its 463. Fevev is excited hy acrimonious irritation in the alimentary 
carial^ or by the increased secretions which take place in the liver and 
other abdominal glands (p. 19). 

Heart-dis- 464. The natural and healthy action of the heart and the whole vas- 

the digestive cular systciu is impaired and reduced below its natural standard, as 

'^^^^^^- exhibited \\\ palpitations^ languid pulse ^ torpor of the limbs, syncope, and 

even death itself, in consequence of the mere application of a peculiar 

offensive substance to the digestive organs (p. 19). 

This paragraph applies to and explains the action of poisons. 

Typhus and 465. The approach of typhus and yellow fever is at all times attended 

^caus^d^by^ by decided symptoms of an existing diseased state of the stomach and 

infect^onact- ^Qy^^i^^ ^^ ^^^ ^ith thoso sigus which are known to point out their con- 

impuHties. tcuts to be of a morbid, irritating nature; but whenever the alimentary 

canal happens to be loaded with irritating matter, some derangement of 

the healthy operation, either of the general system or of some particular 

organ of the body, is the certain result ; and when this state happens to 

be united with any other cause of fever (as infections), its effects are 

Purge with, always thereby much aggravated. It is therefore reasonable to use 

out delay, ^^^y^y ^xcrtion in such cases to expel it as quickly as possible (pp. 107, 

108). 

Malignant 466.*The mcthod which the most eminent practitioners have adopted 
fi/pSnce fi"om experience as the most advantageous is by discharging from the 
teaches p Mr- primoB vicB, as expcdiHously as possible, their irritating and offensive 
Copious de- contents, and in reducing the febrile heat by cold applications (p. 128). 
^ViieTcme' It is also worthy of remark, as it further demonstrates the agency of 
a^ Ju^rvSJ ^^^ contents of the stomach and intestines, in producing organic inflam- 
ing cause of matiou, that in these cases which terminate mostfoAiorcMy the stools are 
all along abundant and bilious, with some occasional bilious vomiting ; 
and that by these free discharges, the intestinal contents being carried 
out of the body as they are collected, their agency as a supervening 
cause of the febrile state is greatly removed, and they are not left to ac- 
quire that degree of acrimony which is necessary to the establishment of 
inflammation (pp. 129, 130). 

Acute rheu' 467. A powerful morbid sympathy is called into action (in acute 
iJsuit ?f irri- rhcumatism), and becomes established betwixt the irritated digestive 
w? wgan?' organs and the ligaments of the joints ; the adjoining tendonous expan- 



cause IS 
moved. 



THE DOCTRINE OF PURGATION. 117 

sions, the membrane of the muscles, and occasionally the muscles them- Pains con- 
selves, often forming organic obstructions, and exhibiting all the severe ti°e"*^priraSry 
phenomena of acute rheumatis'm (p. 210). . . The j^ima/ry cause in the 
digestive organs is entirely overlooked, and so is left to continue its 
action v^ith full vigor ; consequently the daily repetition of the spas- 
modic paroxysm depending upon it, keeps up the local inflammation on 
the sympathizing membranes, and often extends it (p. 220). 

468. These shiftings of the pains, and change of place from one part Atonicrheu- 
of the body to another, depend on the occasional change of place of the Pa^'f^Tift, 
irritating matter contained in the intestines, to one vv^ith wliich some ^id^^matteTs 
other distinct part of the body iias a more direct sympathetic affinity change their 
than that which the pain has left (p. 249). 



location. 



Atonic 
rlieumatiam 



469. The character of atonic rheumatisTn consists in a painful affec- 
tion of some muscular parts, or of their membranes. The pains are not —its charac- 
so severe as in acute rheumatism ; they very frequently wander from 

one part of the body to another, although it often happens that they re- 
main fixed in one part for a long time. . . A particular muscle, or a 
portion of its fibers, become frequently so affected by the sympathetic 
spasm as to be impeded in its free action ; the pain being constantly 
aggravated by the slightest movement of the part, although quite easy 
when the muscle is at rest (p. 24Y). 

470. The remote cause of these phenomena is decidedly seated in the '^^^^^^^^^^ 
digestive organs in atonic as well as in acute rheumatism. They are in matic com- 
their nature spasmodic, only the seat of the morbid sympathy most com- ^Jhe°t?i^esJ-° 
monly appears to be one less susceptible of that inflammation which 
forms the secondary disease of acute rheumatism (p. 248). 



tve organs. 



471. In the treatment of acute rheumiatism much attention is due to thecau^s^the 
the state and circumstances attendinej the primary agastric fever. Expe- mostfre-. 
rience has supported the opmion that, ^n jproportion as the primary is reqwired. 
cause of disease is removed^ the sym/pathetic effect on the membranes of 

the joints hegins also to suhside (p. 221). In order to accomplish this 
object the most free evacuations from the stomach and intestines are re- 
quired^ and the patient generally bears them well (p. 222). 

472. But of a much more painful nature than the atonic rheumatism , Lumbago, 

1 /»77 •••77 1 •7'7» "''^P disease, 

are the cases ol lumbago., sciatica^ tic douloureux^ 2iiia periodical or inter- and uc-doii- 
mitting rheumatism. They are with great certainty to be traced from from^dtSse 
the same remote cause, and, like the former, are only sometimes attended menta,.yca- 
with gastric fever, but are uniformly associated with decided signs of a ^«^' 
diseased state of the alimentary canal (p. 24(1). 

473. All local applications^ independent of clearing the alimentary ^^ii^JtZ 
canal from its contained acrimony, can go no further than merely to pal- only paiii- 
liate the effect of this cause^ but without curing the disease, which will cause mutt 
not happen while the power of the other remains in action (p. 257). \l cJr^'^^^'* 



118 THE DOCTRINE OF PURGATION. 

^cdre'^b-''' '^^'^' ^^^y^W^^^^ is intimately connected with the state of the diges- 
removing tivc oi'gans, wliich is clearly demonstrated by the well-known fact of its 
*^' cause.^^** appearing in various degrees on the skin, m consequence of certain Tcinds 
of food aaving heen taken into the stomachy and this not only in too 
short a space of time after to admit of the chyle impregnated by them 
to be taken into the circulation, but while they as yet remained in the 
stomach, and the inflammation disapjpearing as soon as those contents 
were thrown off {-g. 371). 

Sore-throat 475. Froui the great similarity of the general symptoms exhibited in 
/2c6r"from scarUt fcver to those exhibited in typhus fever, it will be obvious that 
stomach- the treatment here ought to be very similar to that adopted to those 
under typhus ; which is, in the first place, pointed to the mitigation of 
the two great supervening causes of fever — irritation in the primoe vim 
and excess of caloric — especially to that which is seated within the diges- 
tive organs ; the very exhalations from which, ascending to the fauces, 
do, beyond a doulft, tend to heep up the inflammation, and, consequently, 
the ulcerated state (pp. 142, 143). 

Purgation 476. That free evacuations increase debility is in reality an un- 
biuty^^ and foundcd appvehensiou. . , Whatever will act upon the morbid cause, so 

si^enath ^^ ^^ evacuate it from the body, so far from weakening, will assuredly 
tend to restoration of the strength ^ and this is a fact which unvarying 
experience has proved in every instance where nature has not been 
already exhausted by other means (pp. 60, 61). 

The advan- 477. The intention is not merely to preserve the bowels soft, but to 
purgaUoZ discharge from the intestines a lurking cause of disease ', to accomplish 
which purpose very full evacuations are always necessary, procured by 
Examina- the help of the m^ost active purgatives administered in appropriate doses ; 
jections. remarking the nature of what comes off till it puts on a healthy ap- 
pearance (p. 62). 



Impurities 
far more 
weakening 



478. To restore health, purgatives must be perseveringly applied (in 
typhus fever), as it is certain that the retention of any sort of noxious 
than the matter %n the pr%m(B vioi, the tendency of which is m general to lessen 
gatioiu"^' the energy of the nervous system, is inflnitely more debilitating to the 
human frame than the temporary fatigue attendant on the moderate 
operation either of an emetic or purgative medicine, besides the harm 
which may ensue from the noxious matters being partially reabsorbed 

(pp. no, 111). 

Measles. 479. That a state of morbid sympathy betwixt the stomach and 

Swee/ lungs does actually exist in many cases of measles I believe to be cer- 

^*iSig^8^— °^ tain. My belief is founded on the very great relief from pneumonic 

aS^ mau symptoms received by a free discha/rge of acrid matter from the stomach 

ters 'awa.y. and iutcstines — a relief which can be accounted for from no other law 

of the animal economy. Repeated bleedings will, no doubt, tend to 

^^l?d^^ lessen the vascular action, but probably in no high degree, while the 

miUpurga- secoudary cause of fever continues to give its irritation to the nerves of 

u&eies^sj'^nd the stomach and bowels ; and it is obvious that venesection cannot act as 

^^^' a means of removing this cause, neither, indeed, are the more lenient 



THE DOCTRINE OF PURGATION. 



119 



cathartics to be depended on for this purpose ; for although they will to 
a certainty open the bowels, yet they very frequently pass along and leave 
the offending cause hehind. It is the more active powers oi drastic pur- 
gatives alone which are here to le confided in (pp, 136, 137). 



Hamilton, Jr., John. 
Edinburgh^ 1819. 



On the Use and Abuse of Mercurial Remedies. 



480. In pleurisy, from the time that the influence of mercury be- 
comes evident, the general strength rapidly declines (p. Y). 

481. If there be ulcerations in any part of the body, they must as 
certainly degenerate into malignant sores, under the influence of mer- 
cury, as blistered surfaces or scarifications mortify in cases where the 
living powers are much exhausted (p. 9). 



Pleurisy-^ 

baneful 
effects of 
mercury. 

Ulcers — 

become ma* 

lignant by 

mercury. 



Johnson, James, M. D. Critical amd Exflam^atory Remarhs in his 
Periodical, Medico-Chikukgical Review, established' in 1819. 

482. Purgatives in intestinal inflarnimation have been objected to intestinal 
on the ground that they are quickly rejected by vomiting ; but this ob- ^""^tZT^' 
jection is not valid. . . If the first purgative be rejected, it is repeated ^yes'SIf' 
by Pr. Pring in an hour or two, and so on, with various forms of pur- ^^^ .stomach 
gatives, until the bowels are opened, when in general we find the ball IndThe cure 
at our own feet (vol. lY., 1823, p. 259). ^^ ^^^°^^- 



483. Pr. Pring says, " typhus has two origins, one from external Typhus— 
affection, and the other from a spontaneo^pUgjeneration of disease in the ^*^ °"^^°' 
subject affected by it " (ibid., p. 250). 



'W 



Apoplexy 



484. His favorite practice is purgation of a very active kind (Pr., p. f^o"^^^?^ 
102) ; has seen his patients stimulated into fatal apoplexy (ibid., p. lants. 
251). 



485. In the treatment of any form of chronic disease, whether in Chronic du 
the digestive organs or elsewhere, purgatives frequently increase the 
symptoms at first, an effect which is rather desirable than otherwise, 
and it proves that the remedy has a relation with the disease, and is 
capable of subverting this state, if continued for a sufficient length of 
time (ibid., p. 275). 



eases. 
Effect of 
purgatives 
showing the 
remedy to 
have a rela- 
tion with the 
disease. 



By the use of Brandreth's Pills the vital forces change chronic affections into acute. Then 
further purgation with them soon effects a cure. 



486. Pr. Ahercrorribie is of opinion that the only remedies of real Epilepsy. 
eflficacy in epilepsy q^yq purgatives and a strict vegetable diet, wath total purgative!. 
abstinence from strong liquors (ibid., pp. 127, 128). 



487. Constipation in Pregna/ncy. — Pe Lemazurien was sent for on 
the 8th of July, 1823, to see a woman in the seventh month of her 
pregnancy. Abdomen much distended, transverse arch of the colon 



Constipa- 
tion. 



120 



THE DOCTRINE OF PURGATION. 



Fatal con?e- 
queuces of 

the lugltx'f 
of jturffa- 

tioti injj/'eg- 
nancy. 



greatly distended, pulse and appetite feeble, dyspnoea, sleeplessness, 
iaintness, pains in the loins. Lavements were ordered, but it was deter- 
mined to wait till the acconchment was over before the evacuation of 
the bowels should be attempted. 

After child-birth, clysters being employed, the fecal accumulation 
appeared to break up, and there was an evacuation of two or three 
pounds of hard brown fetid matter, but there remained a collection too 
large for expulsion. The patient was worn down by nausea, fever, col- 
icky and other pains, and died 21st September. 

The colon from the csecum to the rectum was found to be intensely 
inflamed. It was a foot in circumference throughout its whole length, 
was filled with gas and with 13-| pounds (French) of solid faeces (1824, 
voL I., pp. 233, 234). 

This case was simple. Two or three doses of Brandreth's Pills would have certainly re- 
lieved, by thoroughly removing all the fecal contents of the bowels. And no danger incur- 
red at any period of gestation to either mother or child by the use of this safe but certain 
medicine. 

Epilepsy. 488. Epihjpsy. — The views of Dr. Chwpman coincide with those of 

The cause -^^' P'^'^ichaTci^ iu placing the cause of apoplexy very frequently in the 

seated in the bowels. He was led to the use of purgatives by the total failure of the 

re°mOTed°by Ordinary plans of treating the disease : " it will not do^ however ^^^ he says, 

plfgauofi. " merely to evacuate the hoijoels ; cathartics must he repeated day after 

day without interruption^ unless absolutely forbid by circumstances " 

(vol. lY., 1823, p. 73). 



Nervous 
diseases 
from 
retained ex- 
cretions. 



Neuralgia 
from morbid 
matter in the 
blood, which 
acts on the 
part predis- 
posed, to in- 
duce local 
disease. 



489. The retention of hilia/ry, urinary^ intestinal and cuta/ineous 
excretions is often the remote cause of diseases of the nervous system, 
as well of the neuralgic £iS> of the spasmodic and ma/niacal groups (New 



Series, 1852, vol. X., 



P- 



^^)# 



490. Whenever there exists " induced local susceptibility " morhid 
elements in the hlood act most obviously in inducing neuralgia. Mala- 
ria may be present therein, yet remain latent and harmless until this 
state occurs. So also the materies morhi of rheumatism or gout may 
fly about until it is specially manifested in some locality rendered 
more susceptible by predisposing causes. It may be observed that 
poisons in general have a specific elective afiinity for certain portions of 
the nervous system (New Ser., 1852, vol. X. p. 103). 



Ail our 491. We find that under certain circumstances a drug does good, and 

medidne^is wc cmploy it whcu tliosc couditious present themselves. The modus 
rimce.^^^^ Operandi is often totally unknown, and though it would be very satisfac- 
tory to know it, yet we can dispense with it, and from experience alone 
prescribe our remedies with very considerable success (E"ew Ser., 1851, 
vol. YIIL, p. 204). 



Erysipelas 
from retain- 
ed and pu- 
trid foBces. 



492. The condition of the alimentary canal should be carefully 
watched in erysipelas, for we have long suspected that it arises more 
frequently from its derangement than the generality of the profession 
are aware. Excrenfientitious matter allowed to putrvfy in the fecal tube 
will not only operate as an irritant upon the whole system, but from the 
close and constant sympathy which holds between the cutaneous and 



THE DOCTRINE OF PURGATION. 



121 



mucous surfaces, may be expected to exert a deleterious influence more 
immediately upon the skin. Hence the erysvpelas Mlcosum and gasi/ri- 
cum of many writers (p. 371, Ser. I., 1828, vol. IX). 

493. In the concluding stages of iliQ putrid fevers^ when the bowels Putrid 
had been long neglected before assistance was procured, we have seen SlSom' 
the most tedious and inveterate forms of the disease (ibid). T<meu. ^^ 

Boyle, James, Surg., A Treatise on Epidemic Cholera in India, Lon^ 
don, 1821. 



purgation 
its cure. 



494. It sometimes happens, after patients are despaired of, tliey have choiera—ita 
a critical evacuation of viscid 'bile. When this circumstance takes place ^^'***^' -"^ 
the patient invarioMy recovers. I have known it to occur in cases when 
the pulse had been almost imperceptible for twenty-four hours. I looked 
on the obstruction of the biliary ducts as a source of irritation to the 
nervous system generally, and the nausea and sickness of the stomach as 
an effort of nature to free herself from an unaccustomed evil. These 
views and a general want of success in practice induced me to embrace 
ideas perfectly new on the subject. Emetics and purgatives were adopted 
as the most likely means to answer the various purposes of clearing the 
stomach, removing obstructions of the biliary ducts, and exciting a new 
action in the vascular system (pp. 51-61, condens.). Many successful 
cases given. 

The very course I pursued in London in 1831, and again adopted in New York in 1849, 
1853, and 1866. 

Chapman, N., M. D., President of Academy of Medicine in Philadel- 
phia. The Elements of Therapeutics and Materia Medica, 2 Yols. 
Philadelphia, 1821. 



495. Gout. — My impression, very concisely stated, is, that this dis- 
ease, if not originating in, has a most intimate connection with, certain 
state of the alimentary canal. It generally commences with those symp- 
toms which denote a depraved condition of the stomach and bowels 
(p. 190). 

496. I have now for many years habitually employed purgatives in 
the paroxysms of gout, and with unequivocal advantage. Not content 
with simply opening the bowels, / completely evacuate by active purging 
the whole alimentojry canal. This being accomplished, all the distress- 
ing sensations of the stomach which I have mentioned are removed, the 
pain and inflammation of the limb gradually subside, and the paroxysm, 
thus broken, speedily passes away. To effect these purposes, however, it 
is often necessa/ry to recu/p to the remedy frequently (ibid.) 



Gk)UT — its 
origin. 



Owe: by 

powerful 

purgation. 



497. Palsy. — Dissatisfied with this course (the usual routine of bleed- 
ing, blistering, and stimulating embrocations to which he formerly had 
recourse) I have for many years abandoned it, and rely now almost ex- 
clusively on evacuating the bowels by the drastic purgatives. Of the 
proprieljif of the change I can entertain no doubt, the success having 



Palsy. 
Bleeding re- 
jected. 



Purgation 
highly sue- 
cestui. 



122 THE DOCTRINE OF PURGATION. 

exceeded my most sanguine expectations. To do justice to the practice, 
U should he steadily persevered in, and aided by snch remedies as the 
case may from time to time demand (p. 193). 

Lloyd, Eusebius, A., M. D., Treatise on Scrofula. London, 1821. 

Scrofula. 198. The very great influence which evacuations from the howels 

have over the rest of the body cannot be denied by any impartial ob- 
-Tt" 'Action server ; it is therefore certain that by increasing or diminishing them we 
explained, are ablc to produce a decided effect on the whole, or, as I have proved 
before, on a particular part of the hody. Thus, if there is much general 
irritation, or local irritation and inflammation, hy increasing the intesti- 
nal evacuation — taking care, however, not to irritate the bowels — we 
may very much relieve both the one and the other (p. 162). 

When Brandretli's Pills are the purgative there is no danger of irritating the bowels. 

iNicKOLL, William, M. D., General Elements of Pathology. London, 

1822. 

Unity of ^^^- ^® speak of the body as being composed of distinct sets of 

the human structuTCS — the vascular, the nervous, the muscular ; or else we treat of 
^^'^^' it after the manner of geographers, as consisting of the head, the thorax, 

Disease not ^^^ abdomcu, &c. Whichcvcr mode we adopt, we acquire a habit of 
local but considering each portion which we enumerate as a distinct and isolated 
genera . ^^^^^ rp|^^ conscquencc is, that when any deviation from health occurs, 
our attention is fixed upon the diseased condition of this particular part 
of the tody, while every other portion is supposed to preserve its former 
healthy state. It is evident that each part cannot he considered as a dis- 
tinct insulated repuhlic, hut as a constituent portion of the general com- 
nmonwealth, whose health is dependent upon a certain condition of every 
portion of the body- (X.) 

Shaw, John, M. D., On Partial Paralysis ; a Paper read hefore the 
Medico- Chirurgical Society of London, in April, 1822 ; a Narra- 
tive of the Discoveries of Sie Ohakles Bell in the Nervous Sys- 
tem, hy Alexander Shaw, Surg. London, 1839. 

Nerves. ^^^- ^7 experiments upon the portio dura he (Sir Oh. Bell) demon- 

Those with strated that it was a motor nerve exclusively, and had no power of be- 

one root nave . ,. ttti , - ,^ \' • • t,i 

only one stowiug scnsatiou. When cut across, m the livmg animal, the motions 
th^se'^'^^mth of a Certain set of muscles were immediately arrested, but the sensibility 
doubie'^fun * ^^ ^^ surfacc Supplied by the nerve remained undiminished. Upon sub- 
tion, namely mlttlug the fifth pair to experiment, a totally different set. of phenomena 
'^ensatitm. presented themselves. This nerve, although it arises from the brain by 
'^'ii'nerwH two roots, has one of its origins nearly four times larger than the other. 

both that ^ ^ It was found that when those branches which proceed simplv from 

onginate , , , ^ .J^ •^ 

frorntjie the larger root were cut across, only one endowment — sensation — was 

^froHifhe destroyed; whereas upon cutting across those branches in which the 

^^rlw'^^^' fihrils of the two roots were united together in the same sheath, not 

only sensation, but the power of motion, were destroyed (pp. 9, 10). An 

attempt was made to apply the new observations, in a similar ♦manner, 



THE DOCTRINE OF PURGATION. 123 

to the pathology of the spinal marrow. Certain affections of the upper 
or lower extremities, supplied by tliese spinal nerves, sometimes occur, 
in which the sensation of the limb is destroyed, while the motion remains 
entire, and vice versa (p. 11). 

601. Now, as it has been established experimentally that motor The cause of 
power belonged to the anterior roots, and sensation to the posterior, it ^Su'^and 
was concluded that when motion, in these cases, was lost, it depended of impaired 
on a morbid condition of the anterior or motor column of the spinal 
marrow ; while, if sensation was lost, it depended on disease of the pos- 
terior or sensitive column (pp. 11, 12). 

These butcheries lead to little good in a practical way. 

602. I shall make a few remarks upon a question which has particu- 
larly excited the attention of physicians of all ages, since the time of pianaUon^S 
Galen, "Why sensation should remain entire in a limb when all volun- the above, 
tary power over the action of its muscles is lost ; or why muscular power 

should remain when feeling is gone ? " . . In answer, Galen said : that 
two sets of nerves went to every part i one to endow the shin loith sensi- 
bility, the other to oi/ve the muscles the power of voluntary action. This oaim's 
opinion was probably founded on a mere theory ; but the facts lately 
discovered, and the observations which have been noted in attending to 
the phenomena of disease, though they do not afford absolute proofs of 
Galen's supposition, still go far to establish the fact^ " that every part of 
the hody which is endowed with two or more powers^ is provided with 
a distinct nerve for each function'''' (p. 13). 

603. The form of the nerves^ which at the same time endow the 

skin with sensibility and the muscles with the power of voluntary mo- '^HXiTmii- 
tion, is such that they appear to be single cords ; but if we examine the ^""J^S&S"* 
origin of any of these nerves, we shall find that it is composed of two root, 
pachets of fibres^ which arise from distinct parts of the spinal marrow. 
These origins are soon enveloped in the same sheath^ so as to appear to 
form a single nerve (p. 13). 

604. It is not too much to suppose that either of these origins may ^^^^^ 

be affected, while the other remains entire. To prove this by ocular eattoni^lnk 
demonstration will perhaps be impossible. But we have already seen tfmtmmt. 
examples of the consequences of injury to a nerve that has a single root, ^fectfo^^g f^' 
viz., the " portio dura ; " for, if we cut it, there will be only one set of proceeding 
actions paralyzed ; while by dividing a nerve which has a double origin, ""Ifoldf or ^ 
viz., the fifth, we shall destroy two powers, namely, voluntary motion ufs^n^the 
and sensibility. We know, also, that when we cut through the tnmk of ^oweu, ai- 
a nerve going to the hand, we destroy both sensibility and the power of ^trp^urga- 
motion. . . If the view here taken be correct, it may lead to this rule of fn^hefoS 
practice: If only one set of functions of a spinal nerve be deficient, we and^"e!rS- 
should apply our remedies to that part of the system from which the ^ng the gen- 
nerve arises ; but if both functions are impaired, we must direct our ^^ ment**' 
inquiries to ^e state of the nerve in the whole course, from its origin to 



124 THE DOCTRINE OF PURGATION. 

its distribution, as the loss of power is probably owing to some affection 
of a part of the nerve after the two sets of filaments, by which it arises, 
are united together (pp. 13, 14, 15). 

— It may here be observed that Mr. Shaw was a piipil of Sir 
Cliarles Bell's, and that his treatise was based upon the latter's 
opinion, given in a short "Essay on the Anatomy of the Brain," 
printed and distributed among his friends in 1809 or 1811. (See 
A. Shaw, p. 14.) 

Being, Daj^iel, M, D., An Exposition of the Principles of the Path- 
ology and of the Treatment of Diseases. London^ 1823. 

#/2f"perito- 505. In enteritis and peritonitis I have trusted more to purgatives 

"testfiS.t-''' *^^^ to bleeding, and I have no reason to regret this confidence. The 

. purge use of purgatives, it has heen objected^ must increase inflamimation j the 

of increasfng effect^ howevcr, is otherwise ; and the testimony of experience must on 

matioJ^^and this as ou othcr occasions, supersede all a priori reasonings. But as a 

why not. matter of reasoning, the conclusion against purgatives on this ground is 
not legitimate (p. 219). 

origmaT^and 506. It docs uot foUow, that au agent which is related with a secret- 

^Sed.^ ing function so as to increase it, should also be so related with inflami- 

mation, which frequently suspends secretion^ as to augment its intensity. 

The danger On the Contrary, in the way of reasoning, it would appear that if secre- 

^purgiiig tiou is suspeudcd by inflammation, that which restores secretion must 

^cienfeS' diminish inflammation. 

ergy. Setting reasoning for the present aside, I suspect that in cases in 

which PUKGATiVES hawe heen supposed to increase intestinal inflammation^ 

it is hecause these means were inadequately employed (ibid.). 

Dyspepsia. 5QY^ Dyspepsia, whether simple or accompanied by disordered func- 
tion of the liver, chronic pains in the side, &c. When the inconvenience 
attending purgation has passed away^ then an improved state of the di- 
gestive organs succeeds (pp. 307-309, condensed). 

^e until ^^^' Chorea. — In the few cases which have occurred to me of this 

healthy discasc, somc of which were severe ones, it has yielded to purgatives in 

*^^p?ar.^^ about three weeks. The stools have commonly in about this period 

assumed a healthy appearance, and the spasmodic action of the muscles 

has quickly ceased (p. 245). 



Chronic 

rheumatism 

— cured by 



509. A gentleman had chronic rheumatism, chiefly affecting his 

_ knees and shoulders. He went out on a cold damp day ; in the evening 

frel purga- \\q had rigors ; the rheumatic pains left the extremities, and he was 

"^ taken with something lihe syncope, sense of constriction at the bottom 

of the throat, of weight in the chest, with a fluttering irregular pulse of 

160 a minute. I gave him a full dose of calomel, salts, senna and jalap, 

which produced eight or ten stools in as many hours. 

The next day he was able to lie flat in his bed. The purgings were 
continued. In four days his pulse came down to 60, and in a few days 
he began to recover rapidly (p. 217). «^ 



THE DOCTEINE OF PURGATION 125 

510. Humoral Pathology may be said to have been perfected by ^^J!^°'^ 
Boerhaave (Preface, p. 1). ^^ ^ ^^^' 

511. So unsettled is the state of pathology that those who read are Medical ig- 
skeptics in all its doctrines ; and those who do not read are left to the norance. 
guidance of a sort of intuition, which is not always productive of happy 
results, but very frequently suggests, through the course of a long life, 

only reiteration of the same error (p. 1). 

512. It appears to me, then, in the case of the " peccant humors," ^^^^^^J^' 
that their phenomena are not produced by a mechanical agency. It is . original 
more agreeable with the results of analytical inquiry to conclude that ''^^Son.^'^ 
the animal poisons contain latent projpert/les of a vital hind^ which are 
related with those of the same hind in living hodies ^ that the phenoTnena 

of disease or death, which ensue from the operation of the animal poi- 
sons in living bodies, are according to the nature of the properties which 
are engaged in this relation (p. ii.). 

513. In my own experience it has been invariably the case, that Bleeding va.- 
those who have sustained great losses of blood suffer more or less from ^j^^^.'^^^^Jj 
what is called determinaUon to the head. The symptoms most common- biood. 

ly are intense pain and throbbing in the forehead or back of the head, 
with a pulse seldom under 90 (p. 23). 

514. It is common in severe and threatening forms of cerebral dis- Bleeding in 
orders^ notwithstanding previous loss of blood, to resort to the lancet, and o?ders/aS! 
to repeat copiously and frequently, if the symptoms continue. I have 
observed that this practice has generally had a fatal termmation 

(p. 86).. 



Cerebral 



515. I have been in the habit of confiding va purgatives to the almost 
total neglect of the lancet ; but these purgatives have not been of a 
milk-and-water kind. I have given 6 grains of calomel, 6 grains of ^"^^f^^^ 
James' powder, followed by a 2-ounce draught of senna and salts with strongest 
half a drachm of jalap in it. If this has been rejected, it has been re- ^Shibited?^ 
]peated in less than an hour, and repeated as often as it was rejected, u/ntdl 
it has produced copious evacuations from the bowels (ibid). 

516. One, and perhaps an important effect of such purgatives, is to 
make a great remdsion to the whole intestinal canal, which is commonly "^l ^action 
followed by almost perfect relief to the head, and perhaps an immediate explained, 
subsidence of the pulse to 100 or 110. The tendency to disorder of the 
head is afterwards easily kept within safe bounds by small repeated doses 
of purgatives (ibid). 



126 



THE DOCTRINE OF PURGATION. 



Crampton, John, M. D., On Tinea. See Transactions of the King's 
AND Queen's Colleges of Physicians in Ireland. Vol. lY., 
1824. 

Rhigtcorm. 517. Tiuea^ or Ringworm. — Having exhausted my patience with 

j7aJ!otr^"'' ti'ials of all enumerated topical remedies, the treatment which I finally 

adopted was, first to use simple poultices, aided by a constant use of 

purgatives., and the tepid bath (p. 60). 

In scald head and ringworm the patient should use Vinegar of Bloodroot as an external 
application twice or thrice a day, and Brandreth's Pills so as to purge freely. Read directions. 



Hosack's def- 
inition — its 
effects if pur- 
gation is neg- 
lected. 

If nahtre 
does not re- 
move impu- 
rities, art 
must, or 
death fol- 
lows. 



JVew TorJc, 1824. 



HosACK, David, M. D., Medical Essa/ys. 

518. " Fever is a disease of the whole system ; the absorbing, the circu- 
lating, and the excreting systems of vessels are all affected by it. . . 
Fever cannot long continue without inducing debility in the heart and 
arteries. It not only wastes the power of the solids, but by the derange- 
ment of the functions and excretions, and especially by the retention of 
those materials which should have been thrown out of the system as 
noxious, which in health are constantly ejected, the circulating fluids 
become changed and vitiated, and thereby become additional sources of 
irritation to the heart and arteries " (vol. II., p. 93). 

From this view we infer that, unless by some salutary power inhe- 
rent in the system itself, or by some means suggested by art, the greater 
irritability of the whole system be diminished, or the morbid changes 
induced in the fluids they circulate be counteracted, these causes of 
fever mutually operating upon each other must increase and fever be 
continued, until the vital principle be totally expended (pp. 93, 94). 



Effects of 
retained 



519. Attention should be daily given to the howels for the purpose 
of evacuating their offensive contents., especially of the lower tract of 
the alimentary carnal / for, these malcontents being retained, not only 
in some instances become the source of irritation to the intestines them- 
selves, producing diarrhoea, but by their absorption into the mass of 
circulating fluids, which are thereby rendered still more malignant, they 
necessarily constitute fresh sources of febrile excitement (p. 98). 



Typhus 520. I believe that the typhus fever of our country owes much of its 

MeSrT' in- malignity to the indiscriminate use of mercury (p. 101 — Report to the 

creases its Govcmors of Ncw iLovk Hospital, Sept., 1819). 

malignity. r > r ? / 



Malignojnt 
pleurisy. 



Bleeding 
destroys. 
Tonics use- 
less, even in- 
jurious. 
Purgation 
saves. 



521. The prudent physician will of course carefully abstain from the 
use of blood-letting and other depleting remedies (in malignant pleu- 
risy). But he will not certainly guard against debility hy the excessive 
use of hrandy and ardent spirits. So far from promoting the excre- 
tions of the system they actually restrain those very evacuations 
which it should be an object to promote, and hy which alone we are 
enabled to counteract the typhoid state of the body in this or any other 
febrile disease (p. 197— Letter of Dr. Hosack's to Dr. T. E. Beck, Feb. 
3d, 1813, on the fatal epidemic prevailing at Albany). 



Brandy and all alcoholic stimulants retard the decarbonization of the blood, because the 
oxygen of the atmosphere has greater affinity for alcohol than it has for carbonic acid. 



THE DOCTRINE OF PURGATION. 



127 



522. Gout is exclusively an inflammatory disease of the whole sys- 
tem as well as of the part affected. Apoplexy^ palsy ^ angina pectoris^ 
asthma, habitual catarrh, eruptions on the shin, obstructed viscera, and 
dropsy, arise from the same habit of body and from the same causes 
— the effects of an overloaded state of the blood-vessels (pp. 234, 235). 



Good, John Mason, M. D., The Study of Medicine, 
1825. 



5 Vols. London, 



Various dis- 
eases from 
retenUon of 
impurities. 



523. Toothache is often produced by a remote cause, as sordes, in the 
stomach (vol. I., p. 41), or whatever tends to render the fluids acrimo- 
nious, as long use of mercury. 

Chronic rheumatism, or acrimony in the stomach, produces nervous 
toothache (ibid., p. 57). 



TootfiaoM 
from morbi(3 
matter in the 
stomach ; — 
also newous 
toothache. 



524. The grand proximate cause of cardialgia, gravel, and gout, is 
debility of the stomach, whence, among other evils, a morbid secretion 
of gastric juice. The debility is not confined to the stomach, but ex- 
tends to the intestinal canal and the other viscera. 

The debility is evident from the habitual costiveness which so pecu- 
liarly characterizes this affection. The imbecility of the liver is equally 
obvious from the small quantity of bile that seems to be secreted, or its 
altered and morbid hue, as evinced by the color of the faeces (ibid., p. 
159). 

525. The lungs are also in many instances apt to associate in the 
morbid action of the digestive organs, when it has become chronic, and 
to produce a peculiar variety of consumption — dyspeptic phthisis (ibid., 
p. 160). 

It must be obvious that, if the chyle which originates in the stomach 
should be conveyed to the lungs in an unhealthy condition, its peculiar 
stimulus must be changed in its mode or degree of action, and the lungs, 
in consequence, suffer (ibid., p. 163). 

The medical treatment : We must restore the debilitated organs 
'10 their proper tone (ibid., p. 164). 



Cardialgia, 
gravel, and 
gout, froni 
disorder ol 
the stomach. 



Costivenesi 
the habituai 
symptom. 



The limgs 
are impli- 
cated ; bad 
blood is 
made, and 
consump- 
tion fol- 
lows. 



526. Colica — colic. — Among the chief causes, acrid, cold, or indi- 
gestible esculents, worms, calculous or other balls congested in the in- 
testines and obstructing their passage, as scybala and indurated faeces 
(ibid., p. 195). 

Cure. — Warm fomentations — clysters. Purgatives should be at- 
tempted by the mouth, though the vomiting is sometimes so incessant 
that we can get little or nothing to stay on the stomach. But the at- 
tempt must be made, and steadily persevered in (ibid., p. 196). 



Colic from 
acrid mat- 
ters. 



Persevere in 
purgativea. 



527. Constipation. — As the faeces are forced forward by the peristal- ConsUpa, 

tic action of the intestines, it is obvious, whenever this action is weakened, MdTi^wers 

there must necessarily be a retardation, and, consequently, an accumu- thiSf *'^*^^' 
lation of faeces. In some instances this accumulation is prodigious. . , 

In one case which ended in death, the cause being mistaken for preg- interesting 

nancy, the colon measured in circumference twenty inches, and on dis- Tendedcofon! 
section was found to contain three gallons of faeces (ibid., pp. 232, 233). 



128 



THE DOCTRINE OF PURGATION. 



Variety of 528. Effects of conMi/poticni^ when long continued : pains in the head, 

nfani?t?ta- naiisea, febrile irritation, general uneasiness in the abdominal region, 
cluSi ^IxSa congestion in the abdominal organs, and hence an impeded circulation 
of tlie blood, piles, varices of the lower limbs, colic (ibid., p. 234). 



Powerful 
purgatives. 



529. lilaxativesfail^ the more powerful purgatives must be had re- 
course to, till the patient cam. habituate himself to evacuate the howels at 
a certain hour every day (ibid., p. 235). 



Diarrhoea 
from acrid 

ingesta ; — 
purge. 



530. Diarrhoea. — Chief causes: "" acridingesta^^ 2xA obstructed hile. 
Often antecedently to the looseness there is a sense of sickness, and per- 
haps a few slight torminal pains. But if the disorder do not prove its 
own remedy, it is easily removed by any common purgative medicine 
(ibid., p. 240). 



ictringents 531. It requircs to be restrained with caution / for a sudden cure, 
-theirimmi- ^nd cspccially a sudden transfer to a state of costiveness, has often pro- 



nent danger. 



duced some severe complaints, and, in one or two instances, epilepsy and 
phthisis (ibid.) 



Worms. 



Purge— 
and why. 



532. Worms. — Dr. Heberden says : " Till some more certain remedy 
shall be discovered, nothing will be more serviceable than to keep the 
bowels loose. By their irritation they augment the secretion of mucous, 
in which also they involve themselves." 

By Tceeping the bowels loose we prevent the accumulation of this slimy 
material in which the worm burrows, and, if we have reason to believe 
that such accumulation has taken place, the best plan is to give active 
purgatives (ibid., p. 329). 



Piles— 533. Piles derive their existence perhaps in every instance from a 

physiology, ^^g^^ ^^^ varicosc state of the amal veins, covered with a slight thick- 
ening of the inner membrane of the rectum (ibid., p. 363). 



faces the 
cause. 



534. Causes : — Local irritation produced by indurated and retained 
fcBces, congested state of the liver and adjoining viscera, (fee. If left 
to themselves, they swell into tumors, and become so painful as to pre- 
vent walking or sitting (ibid). 



'^^ISett. ^^^- JoM'i^^Ge is easily reproduced in those who are subject to it, 
symptoms in- by flatulencc, acrimonious or indigestible food. The bowels are for the 
^^?u5e. ^ most part costive and moved with difficulty (ibid., p. 390). 



Tellow-gv/m 
—purge. 



536. Yellow-gumi — -jaundice of infants. — A dose of any active pur- 
gative will generally be sufficient to remove the obstruction (ibid., 
p. 404). 



537. Fever. — It was the opinion of Hippocrates that fever is an 
?Sti?^° effort of nature to expel something hurtful from the body, either ingen- 
erated or introduced from without (vol. II., p. 44). 



THE DOCTRINE OF PURGATION. 



129 



All fevers 
ire from im- 



538. There is no writer of the present day, perhaps, who has carried 
this view of the subject fartlier, or even so far, as Professor Franh, plTritieTfrom 
who regards typhus, plague, petechise, and all ^ pestilential fevers, and n,eeting\dth 
indeed nervous femrs of amy Icind, whether continued or remittent, not '—"-«♦-= 
only as proceeding from specific contagions in the same manner as ex- 
anthemas, but from contagions producing a like leaven in the system, 
and matured and thrown off through the various outlets of the body, 
by the same process of depuration (ibid., pp. 45, 46). 



impurities 
from with- 
in." 
Dr. Frank's 
opinion. 



539. Typhus. — The term is derived from Hippocrates, and means to 
smoulder, or hum and smoke without vent. When a typhus has once 
arisen, the effluvium from the living body during its action is loaded 
with miasms of the same kind, completely elaborated as it passes off 
(ibid., p. 224). 

540. Br. Haygarth and Dr. Bam^croft show from numerous cases, 
that the miasmatic poison of typhus., when received into the body, con- 
tinues in a latent state at least for seven days from the time of exposure 
to the contagion, before the fever commences. . . . 

A peculiar state of the hody gives a peculiar tendency hoth to gene 
rate and receive typhus.^ whilst some seem to be favored almost with a 
natural immunity (ibid., pp. 227, 228). 



Typhus. 

The body- 
exhales 

miasms. 



The typhus 
poison latent 

for seven 
days ; — frfe 
purgation 
will therefore 
remove the 
poison before 
it is elabora- 
ted. 



Dysentery., 
from the co- 



541. Bysentery : — primary a disorder of the colon, so considered by 
Sydenham and Dr. Cheyne; — first gripings, then dejections, and the ion, -cure: 
fever follows. Sydenham's chief remedy was active purgation twice ^tuon.^^^' 
every other day, with warm diaphoretics on the days when the aperient 
was not employed (ibid., pp. 552-566, cond.). 



542. Eruptive fevers. — ^Whenever any diseased action is taking place 
internally, there is a constant effort exhibited in the part, oi in the sys- 
tem generally, to lead it to the surface, where it can do but little mis- 
chief. . . It is by means of the fever that the disease works its own 
cure, for it is hereby that a general determination is made to the sur- 
face, and the morbid poison is thrown off from the system ; but the 
fever may be too violent, and from accidental causes of the wrong kind 
(vol. III., p. 5). 

543. The grand principle in the treatment of small-pox, as of all 
the other exanthemas, is to moderate and heep under the fever j and how 
ever the plans that may have been most celebrated for their success 
may have varied in particular points, they have uniformly made this 
principle their polar star, and have consisted in different modifications 
of cold water, acid liquors, and purgative medicines — heat, cordials, and 
other stimulants having been abundantly proved to be the most effectual 
means of exasperating the disease and endangering life (ibid., p. 109). 

Br. Mead seems to have been almost indifferent as to the hind of 
purgatives employed, and certainly gave no preference to mercurial pre- 
parations. His idea was, that all were equally beneficial that would 
tend to lower the system ; and in this manner he accounts for the mild- 
ness of the disease after any great evacuation, natural or artificial (ibid.. 



Erupti'oefe- 
'vers—a, nat- 
ural efifort to 
rid the sys- 
tem of mor- 
bid matter. 
The henefit 
of purga- 
tion pal- 
pable. 



Small-pox. 

The fever 
kept under 
by purga- 
tives. 

Strong 
evacuation 
the principle 

of cure. 

Stimulants 

increase the 

power of 



130 



THE DOCTRINE OF PURGATION. 



ffj/pochon- 54tl:. Ili/pochondria. — " The digestive organs are almost always tor- 
causes 7ndi- ^clp Soiiie kind of acrimoiiy is also almost found in the stomach, and 
catethecure. particularly that of acidity. The pain in the epigastrium may be re- 
lieved by the pressure of a belt broad enough to support the whole of 
the lower belly. Congestions in one or more of the abdominal viscera 
are a frequent result, and not unfrequently a primary cause. . . 

Hence w^e see why the hleeding piles are often so serviceable as 
to have obtained the name of " medicina hypochon.driacorum " (vol. 
lY., pp. 158, 159). 

Paeis, J. A., M. D., Pharmacology, Qth Ed., London, 1825. 

mumlnei' ^^^' Purgatives. — The extent of their importance and value were, 
dorsed. howcvcr, ucvcr justly appreciated until the valuable publication of Dr. 
Hamilton on this subject. . . . His practice has clearly proved that a 
state of bowels may exist in many diseases, giving rise to a retention of 
feculent matter, which will not be obviated by the occasional adminis- 
tration of a purgative, but which requires a continuation of the alvine 
stimulant, until the healthy action of the howels is re-established. Sines 
this view of tlie object has been adopted, numerous diseases have re- 
ceived alleviation from the use of purgatives that were formerly treated 
with a different class of remedies, and which were not sitpp)Osed to have 
any connection with the state of alvine evacuations (p. 167, vol. I.\ 

546. Thus in fever the peristaltic motion of the intestines is dimin- 
ished, and their feculent contents are unduly retained, and, perhaps, in 
part absorbed, becoming of course a source of morbid irritation. This 
fact has been long understood, and the practice of administering cathar- 
tic medicines under such circumstances has been very generally 
adopted. 

Emptying 547. But um^tU the publication of Dr. Hamilton, physicians were 

"intestines ^ not awarc of the necessity of carrying the plan to an extent beyond that 
°deS^' of merely emptying the primoB vice, and they did not continue the free 
use of these remedies through the whole progress of the disease (ibid). 

pcKGATivEs 548. Cathartics are essentially serviceable, aiso, in several diseases of 

^^neurosisT ^^ class ncurosis, which are generally intimately connected with a mor- 
bid condition of the alimentary passages (p. 168, ibid). 

549. Chorea and hysteria have been very successfully treated in this 
manner. The diseases incident to puberty in both sexes are also best re- 
lieved by a course of purgative medicines, and their effects in chlorosis 
have conferred upon many of them the specific title of Eramenagogues 
(ibid). 

550. But the therapeutical utility of cathartics extends beyond the 
mere feculent evacuations which they may occasion. In consequence of 
the stimulating action which some of them exert upon the exhalent ves- 
sels, they abstract a considerable portion of fluid fror)i the general current 
of the circulation, and are, on that account, beneficial as antiphlogistics 
(ibid). 

Dr. Paris is sciolistic as to the history of purgatiyes ; their use was better understood in 
the time of Parey (1620) than when Hamilton wrote (1794). 



Fever. 
The peristal- 
tic motion is 
diminished. 



in chorea, 
hysteria, 
chlorosis; 

(" Emmena- 
gogues.") 



Mso good as 
'''■ antiphlo- 



THE DOCTKINE OF PURGATION. 131 

651. For the same reason they may act as powerful promoters of ah- They pro- 
sorption, for there exists an established relation between the powers of J?°^®*^^^'t^ 
exhalation and absorption, so that when the action of one is increased, 

that of the other is augmented. Certain purgatives, as I have just stated, 
exert their influence upon the neighboring organs, and are calculated \ 

not only to remove alvine sordes, but to detach and eliminaie foul con- 
gestions from the hiliary ducts and jpores (ibid., p. 169). 

Why not say the truth, and also remove congestions and relieve pain in the most 
distant organs. 

652. There is no principle in physiology better established than that ^^l^j;^^\^ 
which considers vitality as a power engaged in a continual conflict with conflict with 
the physical^ chemicul and mechanical Ioajos to which every species of ^ ^ ^ ^' 
inanimate matter is invariably subject (ibid., p. 209). 

— And yet chemical remedies are constantly peesceibed hy 
the " SCIENTIFIC " physician ! 

AmsiE, Whitelaw, M. D., Materia Indica. London^ 1826. 

563. Hepatitiso — A viscid and badly prepared bile, producing: ob- Jrvflamma- 

strnction and irritation, is the most immediate sonrce of evil, and so uve'-,^ from 

constantly does neglected constipation precede an attack of hepatitis, anT^'uf^hot 

that we cannot for a moment deny but that it must powerfully contri- fi!!^**f ^^^ 

1 11 • 1 •"! IT*"?* T ScaSOIlS, 

bute towards hurrying on the organic derangement by oindwig up what 
should daily he carried off (p. 549). 

MoNAT and Henderson, Surgs.^ Narrative of the March of the \Zth 
Regiment of Foot^ from. Nuddeah to Berhampoor^ in 1826. See 
• Madras Journal, Vol. II. 

654. Two individuals who were largely bled became convulsed and Bioodutung 
died, and after death it was found that, though the heart was empty, the Sit?u?e^a! 
vessels of the head were loaded with hlood. It was thus clearly indicated 
that, whatever it was that excited the hearfs inordinate action, blood- 
letting would not subdue it y for, as long as a drop of blood remained, it 
was sent to the head (Journ., p. 327). 

Andral, Jr., G., M. D., Clinique Medicate, Paris, 1827. , 

556. In indigestion (embarras gastrique), consisting of loss of appe- indigestion. 
tite, bad taste in the month, loaded tongue, irregularity of the bowels, ^^p*"""^- 
sensation of constriction or weight at the epigastrium, and occasional 
nausea. This train of symptoms we have often seen to resist the appli- 
cation of leeches to the epigastrium, low diet, diluents, etc., and rapidly puT-gaUok 
give way to the exhibition of a brisk purgative. Do purgatives, by ex- *"^^ ^*' 
citing the stomach and bowels together with the auxiliary neighboring 
organs, re-estahVsh the power of digestion f Do these remedies change, 
in some unknown way, the mode of secretion in the liver and pancreas ? 
We know not. But this we know, that the treatment above mentioned 
is very efficacious, and that the antiphlogistic t/reatment is useless, if not ^cs'^iijuri- 
injurious (chap. lY. f). ous. 



Leeches do 

notlessfenthe 

irritation ; 



13; 



THE DOCTRINE OE PURGATION. 



ninsfrative 
cage. 



pulsatiug 
Leeches, 



Nature 

sTiows the 

way to cure. 



556. Andral, in illustration, gives many eases ; !No. YI. is se- 
lected. A young man entered tlie hospital with high fever, violent 
pain in the head, obstinate costiveness, and other symptoms, 
the pendiluvinm, lavements, and tisans were employed to no 
pm-pose. On the tenth day the patient was seized with spontaneous 
vomiting of a large quantity of green bile, which was followed by a 
smart purging of yellow liquid matter. Next day every symptom of 
his malady, was gone. The patient was discharged, " cured by Dame 
N'ature." — Andral asks, " Would not a 'brisk jpurgative or two in the 
beginning have cured the disorder f " 

Why of course they would. Six Brandreth's Pills given on the first or second day 
would have done it. 

'^mldfraie ^^'^^ J^'^'^9<^t^'^^S') ^J rcvulsiou, diminish the actvuity with which the 

the current fluids tcud to the part originally irritated and congested. . . But another 
modify ^the iuflueuce which has been less noticed, is that which they may have upon 
^^iSu^od. *^^ composition of the bloody w^hich they must modify by means of the 
materials which they extract from it. It may be asked, what is the 
nature of their influence upon the blood, according to whether they 
chiefly excite the flow of perspiration, of mucous, or of bile, and what 
changes of composition they may occasion in the blood % This is un- 
doubtedly an interesting subject for investigation (Quoted in Copland's 
Diet., p. 250, vol. I, Art. Blood, § 160). 

Chambers, William, M. D., Physician to St. George's Hospital. On 
Continued Fever. See Beit, and Foe. Med. Rev., 1827, Vol. YI. 

558. Continued Fever. — Those who have been in the habit of treat- 
ing this disease must have observed that in most instances, when pur- 
gatives have been early and steadily administered^ all the symptoms 
have in a short time yielded to them (Rev., p. 161). 



Fe/ver. 
Early and 

steady 
purgation. 



A Treatise on the N'ature and Cure of 
1827. See British and Foe. Med. Rev. 



RTieuma- 

tism. 
Bleeding 
changes 
acute into 
chronic rheu- 
matism. 

Purgatives 
replace 
bleeding. 

Continue 
purgation 
until evacu- 
ations are 
healthy. 
Examine 
stools and 
urine. 



Sctjdamoee, Chaeles, M. D. 
Rheumatism. London.^ 
1839, Vol. VII. 

559. In no way is a degeneracy into chronic symptoms so certainly 
introduced as by that injudicious employment of general bleeding which 
enfeebles the constitution and still leaves the rheumatic disposition in 
great force (p. 70 — Brit, and For. Med. Rev., p. 343). 

560. In proportion as we employ purgatives with judgment, so do 
we diminish the necessity of using the lancet (ibid). 

561. In regard to the freedom and continuance of this treatment, 
we shall inform ourselves in great measure by the nature of the excre- 
tions, alvine and urinary ; for, while the forces are unnaturally dark., and 
the urine is dense^ of a deep color, (fee, it is incumbent upon us to make 
daily employment of purgative medicines (p. 96 — Rev., p. 344). 

Also continue purgation with Brandreth's Pills while severe pain continues, even if the 
stools are healthy. 



562. A course of sarsaparilla often proves useful in that kind of 
chronic rheumatism w^hich is accompanied by general derangement of 
the constitution^ without the particular aflection of any internal organ. 



THE DOCTRINE OF PURGATION. 



133 



We see that, as the health of the system improves, morbid irritability 
lessens, the flesh of the patient increases, his looks and strength improve, 
and the rheumatic pains pass away (p. 370 — Rev. 353). 

Abercrombie, John, M. D., Pathological and PracUcal Researches on 
Diseases of the Stomachy <&c. Edinburgh^ 1828. 

563. It has become a hind of fashion to refer symptoms to morbid 
conditions of the liver, without any good ground for considering them as 
being really connected with that organ. But as a practical man, anxious 
to be guided by observation alone, there are three classes of facts whicli 
have appeared to me worthy of much attention in reference to this sub- 
ject, namely : 

1. That I have frequently seen such complaints get well under very 
mild treatment, as regulation of the bowels, and a little attention to diet ; 

2. That I have seen ^uoi). patients jput through long and ruinous 
courses of mercury without any benefit, and afterwards found the com- 
plaint removed by a course of mild laxatives / and 

3. That I have known patients die of other diseases while these 
alleged affections of the liver were going on, without being able to dis- 
cover in the liver, upon dissection, the smallest deviation from healthy 
structure (p. 320). 

564. In chronic inflammation of the liver free and continued purging 
is expressly recommended (p. 361). 

Annesly, James, M. D., Researches into the Causes, Nature, and 
Treatment of Prevalent Diseases in India. Edinburgh, 1828. See 
Med. Chie. Rev., 1828, Vol. VHP Ser. L 



Dyspepsia 
and SUPPOSED 
chronic in- 
Jlammation 
of the liver 

cured by 

PURGATION. 



Mercury 



Real chron- 
ic inflam- 
mation of 
the Ivei — 

PUBGE FEEB- 
LY AND CON- 
TINUALLY. 



565. Thus, in recruits and other strangers to the climate, on their 
arrival in India, when the biliary secretion is much increased, the tem- 
porary obstruction produced by exposure, wet, &c., often occasion the 
most formidable symptoms of disease, and when the obstruction is over- 
come, an immense quantity of vitiated bile is passed. It is reasonable 
to suppose, if the gall-bladder and ducts be over-distended with their 
contents, then vital contractility may be weakened, and thus the evil 
will be increased, until some internal or external cause supervenes,which 
shall enable the organ to throw off the load which oppresses it, and dis- 
charge its morbid secretion (Rev., p. 419). 



Feviers in 
the East In- 



Natural or 

artificial 

purgation 

alone can 



566. The accumulation of mucous on the internal surfaces of the Mucous ob- 
duodenum may also obstruct the mouth of the common duct, and pre- c«S°o° fe* 
vent the flow of bile into the alimentary canal, until the obstruction be Ji^by'^pSgl- 

tion. 



overcome or removed (p. 307). 



Bayle, M., M. D., On the Inflnience of Gastric Affections in the Produc- 
tion of Mental Maladies. See Revue Medicale. Paris, 1828. 

56Y. Mr. Bayle proves by numerous cases that chronic inflammatiwi 
of the mucous raembrane of the stomach and bowels produced various dT^dstoS- 
forms of insanity, and that the form of the mental hallucination was *<=^- 
often determined by the physical malady in the stomach. 



134 THE DOCTRINE OF PURGATION. 

Brown, John, M. D., Medical Essays on Fever, <&g. London, 1828. 

pToduco? ^'^^^- Malaria produces intermittent and remittent fevers, cholera, dys- 

m;my dis- jy^jma, hHious diafv/ioBa, Uvcr disease, jaundice ; and Dr. McOullock 
cording to adds, rhcumatism and neuralgia (p. 46). 



Cooke, William, Surg., A Practical and Pathological Inquiry into the 
Sources and Effects of Derangement of the Digestive Organs. Lon- 
don, 1828. 



muiation-^— 569. In diseasG there will sometimes be fatal accu7)%ulation offceces 
uponrlporS lu tlio iutestines, when both the patient and attendants report that the 
tfon, buTeSl howels are frccly relieved (p. 129). 

amine. 

^^lioif^' ^^^' ^^™'^s diseases arising from constipation cured hyfull purga- 

tion. 
notltmitent I^ cases of constipation we must be careful that the discharge of 
~uoT^i:T' l<^ose motion does not deceive us, for this may happen without the bowels 
quired;— NO bciug Sufficiently acted upon. We ought never to he satisfied, in any 
u^&" *^^" serious case, without careful examination with the hand ^ for it will fre- 
quently happen, even after fluid dejections, that a large accumulation of 
fceces shall exist. 
Case. On the 12th of December, 1818, I was consulted respecting a little 

boy four years of age, who for several days had been unwell. I pre- 
scribed a dose of calomel, which, in the course of the day, affected his 
bowels three times, the m.otions heing loose and yellow. His diet con- 
sisted chiefly of fluid aliment, and of this he took but little. On the 
pg^gj.^ morning of the 13th he had considerable y^z^^T* remaining. A powerful 
purgation (calomel and jalap) was given. Early next morning he voided 
an excessive quantity of formed and hardened fceces, some parts of 
which were of a hlach color. After this evacuation the febrile symp- 
toms speedily subsided (p. 129). 

Impaired 571. J was cousultcd bv an elderly pjentleman who had been sufler- 



cured by iug uudcr chrouic and protracted derangement of the digestive organs, 

gItion!^^ and who believed that he had kept his bowels freely open by ordinary 

domestic aperients. A more efficient purgative was, however, prescribed, 

and to his surprise and comfort he voided as much solid excrement of a 

hrovm color as would more than half fill a large pot-de-chambre (p. 130). 

'^^ttiol—iis ^^^- Active purgati/ves are not only merely required in cases of accu- 
usefulness, mulatcd faeccs, but are sometimes useful by instituting morbid action, 
by setting up a temporary disease through the alimentary canal. 
Something may he attributed to the increased secretion, but the main- 
tenance of morbid action has sometimes considerable influence in con- 
trolling functional affections which did not originate from gastric dis- 
ease (pp. 131, 132). 

PaipitaUon 5Y3. In evideuce of this view is given a case of palpitation of the 
of the heart, ^g^.^,^ curcd by purgatiou (p. 132). 



THE DOCTRINE OF PURGATION. 



135 



5Y4. A case is given of peritoneal inflammaUon cured by full purga Peruoneai 
tion, when " both the practitioner and the nurse informed me that the ^"Jf"'^'"''- 
bowels were quite ojpen " (p. 130). 



575. In the summer of 1824, I was called upon by a maiden lady 
aged 34. She informed me that for some months she had been in such 
a state of distress, from mental depressions that life had become com- 
pletely burdensome. She had neither inclination for food nor exercise. 
She slept but little and passed restless nights. I prescribed laxatives 
and sea air for a few weeks. She grew worse. On her return to the 
city, powerful purgatives were employed three times a day^ and in a 
w^eek she felt quite a different creature (pp. 192, 193). 



Mental 

deprenHion 

cured by 

■powerful 

purgation. 



576. In 1816, I attended a lady who had " not been well " for two 
years, during which period she had been under the care of a respectable 
medical gentleman without deriving advantage. She was also subject 
to pains in her right side^ appetite impaired^ countenance yellow^ rest 
disturbed. Employed active purgation (calomel and jalap). The first 
day she had twelve dejections ^ the others six or seven each. The pain 
soon ceased, appetite was good, countenance cheerful, and she was again 
feeling comfortable. 

She was now desired to take half the former dose of opening medi- 
cine every third night. 

In this case the constipation had existed so long that it seemed jt?^zf- 
dent to act freely on the howels at fifrst^ and grad%ially lessen the strength 
of the purgative (pp. 232, 233). 



Amenor- 
rlioia cured 
by full pur- 
fjation. 



Case. 



Continua- 
tion of the 
purgative 
treatment. 



577. A lady in the ^^'y^^^^A month of pregnancy had been affected 
for some time with what was considered a guotidian ague. Every day, 
at nearly the same time, she was attacked with rigor and violent shiver- 
ings which continued for half or three-quarters of an hour, and was 
succeeded by hot and sweating stages. On being consulted I deemed it 
expedient to administer some opening medicine hefore other steps were 
taken. The hoioels heing freely acted upon in the course of the next 
twentyfour hours^ the fever did not return (pp. 285, 286). 



Quotidian 
ague 

during 
pregnancy 

cured by 
purgation. 



578. A gentleman informed me that he was recently consulted re- Another case 
specting a family with ague. Barh had been frequently given without Bark useless. 
success. Finding that their howels were much disordered he prescribed 
some opening remedies^ intending to give quinine afterwards, but the 
ague had ceased (p. 286). 



Monro, Alexander, M. D., Morlid Anatomy of the Brain. London. 
1828. See Med. Chir. Kev., Ser. Z, Vol. VIIL, 1828. 

579. Hydrocephalus. — Brish cathartics are to be administered regu- Siriroceph- 
larly, especially at the outset and during the first period of the disease ; bV'reSed 
for the quantity of feculent matter contained within the intestines in wayVpurgl 
many cases is really surprising. One instance now occurs to us. The /f^l^ "'^^ 
patient was a young lady who, after an attack of fever, during which 



136 THE DOCTRINE OF PURGATION. 

head symptoms predominated, and had not been opportunely nor snffi- 
case. eiently overcome, was seized with all the signs of water in the he-ad ; 
and as her bowels had been rather disposed to astringency throughout 
the fever, they became exceedingly torpid, indeed almost unraanage^ 
able, on the establishment of hydrocephalus. 

Five or six cmnmon doses of drastic purgatives were required 'before 
fetid stools. '^^^^ bowels would answer^ and fetid and bulky stools were daily passed 
for three weeks under this stimulation^ without any solid food having 
been taken during that time (p. 38 — ^Rev. p. 385). 

580, And instituting a new and healthy action in the secretory appa- 
ratus by a degree of warmth and local remedies adapted to the sensibility 
of the part afiected (ibid). 



McKenzie, William, M. D., A Sketch of the Natural Cure of Dis- 
eases ; in Glasgow Medical Journal, February^ 1829. See Burr. 
& Foe. Med. Eev., 1847, Yol, XXIIL 

evS^^haSgl ^^1- The body is almost altogether fluid ; nine-tenths of it are so, 
i^l^^'i^ever and only one-tenth solid. The fluid parts a^e in a perpetual state of 
disease, change, being decomposed by one set of functions and recomposed by 
another. . . . Our fluids, by means of digestion, absorption, circula- 
tion, respiration, and secretion, are in a constant revolution. By these 
processes there is eflected an uninterrupted decay and restoration of the 
body ; and one can not doubt that the natural cure of diseases depends 
very much on the existence and on the perfection of this revolution. 
ISTay, it is extremely probable, that one of the principalintentions served 
in this mode of carrying on life is the prevention and removal of dis- 
ease (Rev. p. 587). 

By purgation with Brandreth's Pills we can change the entire body in from a third to 
half the time it is changed in the ordinary course of nature, and with entire safety. Case 
of 

Stephens, Henky, Surg. Treatise on Inflamed and Obstructed Hernia. 
London, 1829. See Med. Chie. Rev. Ser. Z, 1829, Yol. XL 

strangu- 582. Mr. Lawrcncc has, under the head of " slow strangulation," 

^frfm™^ described a state of obstructed hernia from fecal accumulation, and 
tained fseces. without doubt such a stotc oftcn cxists (p. 62 — Rev. p. 112). 

Brandreth's Pills to this poor patient would have been the complete doctor, producing 
certain relief, and, in all probability, would have cured the rupture. 

Stokee, William, M. D. Treatise on Continued Fevers, c&c. Dublin, 
1829. 

Typhus 583. Typhus fever is connected with morbid changes that previously 

'^^^' take place in the fluids, and produce morbid actions, and sometimes 

permanent change of structure in the solid parts. These changes are 



THE DOCTRINE OF PURGATION. 



137 



distinguishable from those which occur in inflammation^ and the morbid 
action excited relatively by these changes in the blood are also distinct. 
In inflammatory fever, increased action ; in typhus fever, debility is 
almost the immediate consequence (p. Y4). 

The remedies employed by me in mixed and typhoid fevers, and 
arranged according to their relative importance, are : 

Mixed fevers — cleanliness, ventilation, cool regimen, plentiful dil- 
uents, and purgatives. 

Typhoid fevers — yeast, wine, am^d aperients (p. 113). 



definition 
and modus 
procedendi, 



with 
purgative 
medicines. 



684. In both ague and intermittent neuralgia, I believe the disor- 
dered function of digestion, and the consequent morbid condition of the 
chyle and of the other contents of the stomach, whether ultimately 
absorbed or carried into the sanguiferous system, or carried downward by 
theprimcB vice, become in their transit a chief cause of all the succeed- 
ing symptoms (p. 35Y). 



Ague and 
neuralgia 
from re- 
tained im- 
purities. 



5^6, When these periodic diseases become, however, more estab- These impu- 
Ushed, it is probable that not only the fluids are further affected, but caus^^of^or- 
that consequent changes are excited, and hence the morbid condition of somIc du- 
the fluids may be the primia^^ source of organic disease (ibid). 

The following quotations establish the absolute necessity of having by us a purgative to 
which we may always apply with safety for relief; and we have it in Brandreth's Pills. 

Copland, James, M. D. Dictionary of Practical Medicine. London, 
1830. JSTew Yorh Ed. by Dr. Ch. A. Lee, 1846-1852. 



586. A belief is too generally entertained that fecal matters and 
sordes will not accumulate in the colon unless the patient has been con- 
stipated. But they m.ay collect in its cells, the more central part of the 
canal allowing daily evacuation y and they may even remain there for 
a considerable period, producing much irritation, and even a relaxed 
state of the bowels, thereby misleading the judgment of the prac- 
titioner as to the pathological state constituting the disorder. ... In 
many cases, when the morbid collections have become acrimonious, an 
irritative diarrhoea continues for some time, or recurs at intervals, before 
the morbid matters are fidly thrown off, owing to spasmodic constric- 
tions of parts of the bowels. . . On these occasions the evacuation is 
often preceded bv gripes, tenesmus, or a scalding sensation in the anus 
(vol. I., p. 450, Art. Colon, § 6). 



Fecal matter 

may 
accumulate 
where there 
is no con- 
stipation — 
watch and 
purge. 



Effects. 



587. Purgations are used in order to occasion a local determination of 

blood, and thus derive it from the seat of disease, to evacuate the vis- — tS^ac- 

cera, increase the discharge from the mucous surface, and augment the ^Ss ^°^ 
secretions in adjoining organs (ibid., p. 218). 

588. Y\\Q fetor, <&c., of the breath, and of the perspiration, &c., con- interrupted 
sequent upon interruption of the abdominal secretions, indicate that im- secretion- 
purities have accumulated in the circulation, and that they are being ac^w»»ofthe 

elimin ated by the lungs and the shin. So long as the vital energy is gln"'°^^ °^* 



Causes of 



138 THE DOCTRINE OF PURGATION. 

sufficient for the due performance and harmony of the functions, inju- 
rious matters are seldom allowed to accumulate in the blood to the ex- 
tent of vitiating its constitution^ witliotit heing discharged frmn it hy 
means of one or move oi^gans. But as soon as this energy languishes, or 
is depressed by external influences and agents, and the blood is thereby 
either imperfectly formed or insufficiently animalized and depurated, 
some one of its ultimate elements or proximate constituents become ex- 
"disease? ccssive, aud the chief cause of disorder, which terminates either in the 
removal of the morbid accumulation^ or in a train of morbid actions and 
lesions (vol. L, p. 23 8, Art. Blood, § 116). 

Defective 589. Thus it will appear that changes in the secretions and in the 

cauS'ab- hlood itsclf are most influential in the production, perpetuation, and 
sorption of aggravation of disease. . . Thus, also, it will appear not only that hurt- 
uvTitiating ful mattcrs carried into the circulation, and ultimate elements or proxi- 
and^produc- ^ate constitueuts allowed to accumulate in it, owing to the imperfect 
ing disease, performance of some alimentary function, will be removed from it when 
the vital influence is sufficient for the task, but that both kinds of inju- 
rious agents will, according to their nature, become productive of a viti- 
ated state of the blood, of the secretions formed from it, and even of the 
various tissues themselves, when the state of vital manifestation is insuffi- 
cient to remove them from the frame (ibid,, p. 239, § llY, ibid.) 



Defective se- 



590. I consider the grand path^^logical inference to be fully estab- 
creTion,ifnot lishcd : that the interru^on or obstruction of any important secreting or 
by^icarious cHifivnating function, if not compensated by the increased or modified 
duce°'«S- action of some other organs, vitiates the blood more or less ; and if such 
ted blood, vitiation be not soon removed, by the restoration of the function prima- 
rily afiected, or by the increased exercise of an analogous funcjtion, that 
still more important changes are produced in the blood, and ultimately 
in the soft solids, if the energies of life are insufficient to expel the cause 
of disturbance, to oppose the progress of change, and to excite actions 
of salutary tendency (ibid., p. 240, § 121, ibid.) 

Mirisma— 591. Miasmata produce a morbid impression on the nerves of organic 

action on life, followcd bv dcpressiou of the vital iufluence : the functions of diqes- 

orgamc life, . ' ,'• f -7 ^ • . . i, • i' . i? '^ ^ p 

impairing Uon and sccrctiou languish, and, owing to the imperiect periormance oi 
tkfn T*The' secretion and assimilation, the necessary changes are not fully effected 
Relcuon if ^'^ ^^^ blood, and thus the irritating and otherwise- injurious matters ac- 
thereissuffi. cumulate \A it. . . The vascular system becomes excited by the quantity 
"^—^^^7% and quality of its contents ; and when the vital energies are not too far 
noj^"*^' ^ depressed for its production, the excitement becomes general. The ac- 
celerated circulation has the eflect of exciting the organic functions, of 
restoring the secretions which were impeded or interrupted, and thereby 
of removing the morbid state of the circulating fluid, after which the 
return of health is rapid. When, however, salutary reaction is not 
brought about, owing to the morbid depression of the vital energies and 
to changes which had taken place in the blood, the vitiation of the blood 
jproceeds ', the secretions are also vitiated, the solids affected, one or 
more vital organs suffer in an especial manner, the energies of life are 
exhausted, and various organic lesions are induced, having reference to 



THE DOCTRINE OF PURGATION. 139 

the previous state of the system, the kind of changes produced in the 
blood, and the agencies in operation during the progress of the disease 
(ibid., p. 240, § 125, ibid.) 



692. M. Andral states that " he has often found in the hlood-vessels Morua/or- 

matioriH in 

body im- 

morbid 

matters to 



a Qurdy, friable matter^ of a dirty-gray color ^ and resembling either the S2 
semi-concrete pus of chronic abscesses, or the sanies of malignant ulcers, ^^[^ 
or cephaloid matter, broken down and mixed with blood." And similar the ulod. 
instances are recorded by Bichat, Beclard, and Yelpeau. In all these 
cases, abscesses, tubercles, or other morbid formations, also existed in " 
some part of the body (ibid., p. 246, § 144, ibid.) 

593. Morbid secretions should \iQ frequently evacuated^ in order that Evamau 

vital power may not be further reduced by their morhid impression on tions\<fpreI 

the nerves and mucoris digestive surface^ and that the possihility of the Son^f impS^ 

absorption of any part of them into the circulation may be thereby ^^*i«s- 
avoided (ibid, p. 249, § 158, ibid.) 



accu- 
mulations. 



594. In all the alterations of the blood resulting from the introduc- Bloodletting 
tion or absorption of morbid matters from parts previously diseased, sorption ^Xt 
whatever tends to lower nervous and vital power ^ or to promote absorption S??^*^ ™*** 
— m.ore particularly blood-letting^ which operates in both these ways — • 

ought to be guarded against, and a diametrically opposite plan of cure 
adopted, not neglecting the promotion of the depurative and excreting 
functions (ibid., § 159, ibid.) 

595. Fecal matters collected in the coecum often induce inflammation^ ^ef^Tn "tS 
or the paroxysms of pain are very acute, sometimes attended by vomit- cceoum. 
ing and all the symptoms of the most severe colic, or even those of ileus various and 
(§ 10). The symptomatic disorders, when the viscus is much distended sequ^icerof 
either by fecal or by other matters, or by flatus, are numbness of the ^^^^ 
right thigh, oedema of the right foot and ankle, sometimes retraction of 
the testicle, or frequent calls to empty the bladder, and sometimes 
hemorrhoides, uneasiness and pain in the right iliac region, often extend- 
ing to the hypochondrium, various dyspeptic symptoms, costive or irregu- 
lar state of the bowels, occasionally diarrhoea, with scanty, oifensive, and 
mucous stools (§ 11). The efforts made to evacuate the bowels are often 
attended by severe tormina and even retching. I have seen several 
cases of varicose veins of the leg, or indolent tdcers, and a case of disease 
of the bones of the foot, the occurrence of which was evidently connected 
with great disturbance and accumulations in the ccBGunh. . . The com- 
plexion is deficient in clearness, and with the surface often covered with 
an oily or dirty moisture ; the perspiration becomes fetid and the breath 
offensive ; the soft solids lose their elasticity, and are slightly emaciated ; 
. . . and at an advanced stage the symptoms more clearly manifest that 
the blood is imperfectly depurated, or that it is affected by the absorp- 
tion of a portion of the excrementitious matter retained in the caecum. 
In addition to these symptoms, general debility and disinclination to any 
physical or mental exertion are often complained of (§§ 10, 11, 12 ; Art. 
Colon, p. 330, ibid.) 



from 



140 THE DOCTRINE OF PURGATION. 

Cholera— 596. Eveii in cholera^ in which tlie eruption of an increased quantity 

secretions;— of morbid secretious into the duodenum occasions copious discharges 

b!™*'yM/va^ from the stomach and bowels, ^i^ith cramps, &c., we are not justified in 

lion. conchiding that any organic change is present beyond simple irritation 

of a temporary kind, excited in the mllous surface hy the acrid state of 

the secretions passing along it (ibid., p. 624; Art. Digestive Canal, 

§17,B). 



causes. 



Chorea— \u 59T. Auioug the chicf predisposing causes of chorea is a neglected 
' ^^^^' state of the bowels, leading to accumulations of deranged secretions in 
the primse viae, torpid functions of the liver, and other secreting and as- 
Bimilating organs. The most exciting causes are the irritations of warms, 
oi morhid matters accumulated in the bowels {Stoll, Baldinger, and 
We?idt), and fright, improper employment of lead, mercury, &g. {De 
Haen)^ suppressed eruptions and discharges {Thilenius, Darwin, and 
Wendt.) (Ibid., p. 389 ; Art. Chorea, § 12, III. 13 B.) 



Cure : — re- 
move the 



598. Purgatives have been recommended in chorea by /Sydenham, 
Su^se /by Whylt, Hamilton, Cheyne, and others (ibid., p. 392, § 23, YL, ibid;) 
purgaUves. fj^he first indication is to remove marhid secretions 2i,ndi fecal accumu- 
lations, the usual cause of the irritation of the organic nerves (ibid, p, 
394, § 29, B, ibid.) ' 

Diarrho&a. 599. Idiopathic diarrhoea, when recent, requires demulcents or dilu- 

m^rbfd^ma?- ©^^ts merely, in order to facilitate the discharge of acrid or accumulated 

'«'' "^^^l^^^ matter. This having been accomplished, disorder soon ceases. But the 

away^ irritating substances may be partly retained and keep up a prolonged or 

remittent state of the disease, with griping pains and scanty stools, which 

may be partly feculent, mucous, or serous — the latter predominating, 

when the irritation is considerable. In tliis case much discrimination is 

requisite in selecting the aperient which is obviously required ; for, if it 

be insufficient, the disorder will be prolonged (ibid., p. 609 ; Art. 

Diarrhoea, § 25, YII.) 

Beandreth's Pills are all that is needed, and discrimination is not required. 

Crisis— iiius- 600. Illustration of Crises. — A person exposed to the causes of 
OMtumnal fever of a bilious and remittent form, experiences during the 
earlier stages the usual symptoms of impeded or interrupted secretion, 
The removal ^^^ general vascular excitement. In consequence of interrupted action 
of morbid of the emuuctories the blood contains an increasing proportion of effete 
Se"yst°em.*^^ materials, particularly of the elements out of which bile is formed. 
These for a while increase and modify the vascular excitement, or, when 
excessive in quantity, or especially noxious in quality, even tend to ex- 
haust or depress it. But they at the same time b^ng appropriate 
stimuli to the biliary and depuratory viscera, serve to restore their 
impeded functions, to turn the balance of excitement in favor of them, 
thereby to reduce the morbid vascular action, to cleanse the circulating 
fluid from its impurities, and to change in other respects its condition, 
and thus the disease termiriates with an apparent collapse, followed by 
a copious discharge from the bowels, consisting of morbid bile and of 
the excretions from the intestinal mucous surface — the products of the 
noxious matters which had accumulated in the blood, but which is now 



.THE DOCTRINE OE PUKGATION. 



141 



heing eliminated from it^ hy a renovated as well as an increased secret- 
ing and excreting function. Now, tins procession of morbid plienom- 
ena shows, that the ancients were not so far wrong as many of the 
moderns suppose, when they Relieved that critical evacuations were hene- 
ficial, chiefly hecause they conveyed a morhid matter out of the system 
(ibid., p. 516, Art. Crises, § 15). 



601. As the office of the excreting organs is to expel those elements 
which are effete^ and would he injurious to the frame if retained in the 
hlood^ it must necessarily follow, that any interruption to their function 
must be highly injurious. The dropsical effusions in various cavities 
following interruption to the action of the kidneys, fully illustrate this. 
As a large quantity of ingested matters is carried into the blood, either 
directly from the stomach or along with the chyle, and discharged from 
it by the emunctories, it is evident not only that the kind of ingesta will 
aifcct very remarkably the properties of the excretions, but that obstruc- 
tion or interruption of any one of them will be followed by serious effects, 
unless some other organ perform an additional office vicarious of that 
which is suppressed^ and even in this case disease will generally ulti- 
mately arise (ibid., p. 668, Art. Diseases, § 99). 



In disease 
impurities 
must here- 
moved by 
the proper 
cm^wactoiies 
or vicAKious- 

LY ; if NOT 

FULLY EE 

MOVED, dis- 
ease quietly 
follows. 



602. What are most diseases^ but either suppression or excess in 
secretions or excretions f (ibid.) 



fJlQ What disease 



of irritating 
quality the 
essence of 
the disease. 



603. Dropsy from, Disease of the Kidneys. — In a very great major- ^J^Jf|;~^J 
ity of instances, where effusion proceeds from this cause, the irritating uousjixad 
nature of the fluid poured out, superinduces inflammation of the mem- 
hranes and cellular tissues containing it, and thereby aggravates the 
disease, and accelerates a fatal issue / for if it be considered that when 
the functions of the kidneys are interrupted, excrementitious or serous 
plethora will be the result ; and that the watery parts of the blood which 

are effused from this cause must necessarily contain a considerable 
quantity of the injurious matters usually eliminated hy these organs^ 
the irritating quality of the accumulating fluid here contended for will 
be admitted (ibid., p. .Y05, Art. Dropsy on the Chest. § 52). 

604. Purgatives are very applicahle in dropsies generally^ on account Purgatives, 

- - - - ._ . -_ - uCC3iU.SG rC" 

moving the 

m deriviiig from the seat of effusion, in draining the ^^Se^^^^" 



of their deobstruent operation when uninterruptedly continued, or of 

their influence 

fluid parts of the blood from that circulating in the intestinal tubes, in every form 

thereby lessening excrementitious or serous plethora, and favoring the the disease. 

absorption of the effused fluid. They constitute a most important part 

of the treatment of every form and state of the disease (ibid., p. 710, 

§ m, ibid.). 

In hydrothorax, cathartics and purgatives, especially the hydra- 
gogues, often afi'ord speedy relief (ibid., p. 739, § 172, ibid.). 



605. Frequently affection of the hrain is induced by irritation of the 
gastro-enteric surface. In children this is remarkably common, and 
even in adults a slight degree of disorder of the stomach is often fol- 
lowed by headache, somnolency and incapability of mental exertion. 
The occasional dependence of epilepsy in adults, and of convulsions in 



stomach- 
disorder 
causes nu- 
merous dis- 
eases of a 

nervous 
character. 



142 THE DOCTRINE OF PURGATION^ 

cliildreii, upon morbid action in the digestive canal is well known. In- 
fiammation of the ineiiibranes or of the substance of the hrain^ and acute 
hi/drocej)halus sometimes also supervene upon gastro-intestine irritatiou, 
and in the course of their development render oLscm-e, or entirely mask, 
the previous ailment. For, as LaJlemand lias remarked, as soon as the 
cerebral aitection even partially obscures sensibility the existence of dis- 
order in the digestive canal is ascertained with great difficulty. In my 
opinion, the majority of cases denominated ''' spinal irritation'''' are 
caused by gastro-enteric disorder (vol. II., p. 30, Art. (lastro-enteric 
Disease, § 3). 

— thefr" j?(5- ^^^- ^ judicious exMHtion of purgatives will frequently remove 
cious use re- imtatiou of the digestive canal, especially if it be caused by unwhole- 
Sustof dis^- some ingesta or morbid secretions, or fecal accumulations ; and even 
^^how°*^ when it cannot be referred to either of these, but rather to the state of 
vascular action in the digestive surface, the augmented secretion pro- 
cured by refrigerent or mild purgatives may promote its resolution or 
diminish its intensity (ibid., § 4. ibid.). 

'Pneumonia 607. Evcu the occurrencc of vneumfmia may be favored by disorder 

of the skin 01 the Qigestivc caual (ibid., p. ol, § 7, ibid.). 

samTsoSce. Its councction with diseases of the shin^ is much more general than 

practitioners suppose. It is chiefly owing to the irritation of the diges- 

Arsenicin- tivo mucous surfacc, that the cutaneous affections resist so long the treat- 

taneous^^S mcut prescribed for their removal. I have repeatedly seen arsenical 

®*^®- and other irritating medicines exhibited in no small quantities ; and 

although they were evidently exasperating both the internal and external 

affections they were continued with a perfect belief in their applicability 

(ibid., p. 33, § 15, lY., ibid.). 

Impure 608. Whcu the disorder of the gastro-intestinal surface is attended 

diseaseT'^^of with a crovhig or morhidly excited apjpetite^ food is taken in larger quan- 
wdneys^aAd "^ity tliau it cau be digested, and much imperfectly formed chyle is 
skin. carried into the hlood where it excites disorder of the liver ^ of the hid- 
neys^ and often of the shin^ in the course of the excretion of the un as- 
similated matters by these organs (ibid., p. 34, § 16, ibid.). 

Manydis- 609. The supprcssiou of the excreting functions of the shin may be 

oxif^ciusE- followed — especially if the kidneys do not perform a vicariously increased 

if'the^wL function — by catarrh, or by rheumatism, or by inflammation of the 

hVim'^er!lct ^'^^9^ OY plcura, OY by diarrhoea^ or by dysentery, or by enteritis, accord- 

'ixcreting iug as the precHsposition of parts may deterinine the morbid action. 

^ra?sKiN?^ The cause or causes, whether exposure to cold or to influences depressing 

vital power, occasion, first, interruption of the depurating functions of 

the skin, and next, more or less congestion of, or vascular determination 

to, internal viscera or parts ; and, in addition to this latter effect, and as 

a consequence of the suppression of the cutaneous function, the hlood is 

loaded with these excrementitious elerfients which the healthy action of 

the skin eliminates. The resulting conditions of the blood and of the 

circulation are such, in many cases, as kindle diseases, either those above 

mentioned or others of a slighter or severer nature (vol. III., p. 1137, 

Art. Therapeutics, § 44). 



THE DOCTKINE OF PURGATION. 



143 



610. What has been said respecting the functions of the skin, applies The same is 

likewise to the other excreting and secreting functions. Of all excreting uhl/[ecre- 

or depurating functions, those performed by the kidneys are the most excretories""^ 
rapidly fatal when impaired (ibid., p. 1138, § 47, ibid.). 



Constant of)- 

aen-ation of 

evacuations 

necessary, 

and why. 



This applies 
to 



611. The cure. — It is helieved by many that the regular and daily 
evacuation of the howels is quite sufficient y hut this may not always le 
the case^ as to either the fecal discharge or the hiliary secretion, or even 
as to hoth. . . Hence the importance of observing accurately the ap- 
pearance of the intestinal excretion, both in health and in disease, and 
of having recourse to such means as those appearances, the frequency brandrf.th-s 
of the evacuation, and the associated state of the disease will suggest. ^^^^^• 
The several substances employed as purgatives and cathartics should be 
suited to the peculiarities of each case, and be conjoined with others of 
the same class, or with such as may either correct or promote their ope- 
ration (ibid,, § 48, ibid.). 

With Brandreth's Pills you can obtain any desired effect upon the bowels or general 
system. 



Changes in 
the hlood 
fromretained 
impurities 
resulting 
from a defi- 
ciency of the 
secreting 

and 
excreting 
functions. 



612. The promotion of the several secreting and excreting functions, 
whenever they are torpid or impaired, is requisite to the prevention of 
many contingent evils during states of vital depression, by whatever 
cause produced ; but it has a still more general application, for, in all 
circumstances, in states of excitement and increased vascular action, as 
well as in those of depression, these functions are very often either tor- 
pid, or impaired, or even interrupted, and require restoration ; other- 
wise additional or more severe and dangerous changes result, and the ^^^^^ versa. 
hlood, loaded with excrernentitious materials, occasions the most delete- 
rious effects in vital organs (ibid., p. 1137, § 42, ibid). 

613. Next to the sedative or depressing effects produced by the Cure:—hy 
causes of disease, the impairment of depurating functions closely fol- [mpSfs!''^ 
lows, the latter being very frequently the cause of the former. These 
functions are often restored hy the same means as are employed to remove 

the primary morbid impression (ibid., § 43, ibid). 

614. In chronic, maligna/rht, and structural maladies, the constitu- 
tional or vital power is impaired, and the hlood is altered more or less 
as these maladies advance, especially cancer, t'libercle, riclcets, &c., the 
alteration of the blood becomes more or less evident, this fluid being 
thinner, poorer, or deficient in red globules. Hence the necessity of sup- 
porting the powers of life by means which will neither excite nor irri- 
tate them, and of preserving the healthy state of the blood by conjoin- 

.ing with those means such as will correct or prevent alterations of this 
fluid, and will, at the same time, promote the conversion of the color- 
less or chyle globules of the blood into red globules — will promote the 
processes of sangidfication and nutrition (ibid., p. 1142, § 63, ibid). 

615. A person is exposed to causes, as infections, which depress or- 
ganic nervous energy, and thereby impair or suppress the more import- 
ant depurating and secreting functions. The consequences as respects 
the blood are obvious. This fluid soon abounds in effete and injurious 
elements, increasing both the amount of the vascular contents, and 



Chronic dis- 
eases from 
impoverisJb- 
ed blood. 

The cure by 
promotion of 

sanguifica- 
tion and nu- 
trition ; oth- 
erwise using 
Brandreth's 
PiUs. 



Effects of 
impurities 
ill the hlood. 



144 THE DOCTRINE OF PURGATION. 

Brandreth'3 opprcssiiig and irritating tlie wliole vascular system, although certain 

Ks** '^'S organs may manifest these effects in a more prominent manner than 

fhr'"^s>^'tim others, until a salutary crisis is observed^ and the morbid state of the 

into" a hJ^od IS removed^ or until the soft solids are changed, their vital cohesion 

dftiJn.^ *^°°' is loosened, and disorganization ensues (ibid., p. 1046, Art. Sympathy, 



The mutual 616, There is very intimate connection existing between the state of 
excreting or^ the blood and the depurating offices of the mucous surface of the intes- 
talnedWcre- tines, cspccially of the large intestines. This surface, and more partic- 
duce^amon» ^^^^^l^' ^lie follicular glauds, may be considered as eliminating from the 
other eS^ bloocl reduudaut or decomposed blood globules, and much eifete mate- 
^eSs^i. e!' rials, and as thereby contributing, with the other emunctories, to the 
^chan'ge?^ puritv and healthy condition of this fluid. The connection subsisting 
between the functions of excreting viscera, not only as altering the con- 
dition of the blood, but also as affecting each other individually y the 
influence which the state of one depurating function exerts upon the 
others through the medium of the blood, as well as through that of the 
organic nervous system, and the mutual and conjoint operation of all 
these functions, not merely in changing the physical appearance and 
constitution of the blood and the states of vital influence, but also in 
occasioning structural alterations, are among the most important topics 
comprised'by a rational system of pathology (ibid., p. 1045, § 96, ibid). 

^OT^ciou^s"^ 617. Predisposing causes of worms should, as much as possible, be 
mucous and Tcmovcd or Counteracted. In furtherance of this indication, the diet and 
^sordes!^ the treatment should be adopted that are most efficacious in promoting 
the organic nervous force and the tone of the digestive organs, and in 
removing tenacious mucous and pituitous sordes, which often adhere to 
the digestive mucous surface, and which often forms the nidus in which 
the ova of parasites are lodged and hatched. It will generally be no- 
ticed that the secretions and excretions which in all persons form the 
principal part of ihe fecal discharge are seldom thrown off from the se- 
creting surfaces so quickly and entirely in the delicate and debilitated as 
in the robust and healthy, but remain or are retained in the former class 
of subjects, andbecome the soil in which these animals are reared (ibid., 
p. 1547, Art. Worms, § 158, B). 

Spasms. g^g^ Spasms of the voluntary or involuntary muscles. — Purgatives 

curebypwr- are generally beneficial, more especially when the liver or brain is con- 
gested, and when the spasm is connected with acidity and flatulence of 
the digestive canal, or with accumulation of morbid secretions, excre- 
tions and fecal matters, as when spasms occur in colic, or in the course 
of gout, rheumatism, hysteria, hypochondria, &c. In these, as well as 
in some cases of other diseases, not only are morbid excretions thus 
liable to accumulate, but the hlood becomes more or less contamiriated by 
effete materials, which the impaired functions of the emunctories fail of 
removing. 

.J?!r^.^^ ^19- In these circumstances purgatives should be selected with this 

the bowels vicw, uot merely oi evacuating the contents oi the bowels, but also of 

^eimt promoting the functions of the excretory organs. When cerebral con- 



THE DOCTRINE OF PURGATION. 



145 



gestion is connected with tlie spasms, then active derivative purgatives 
ought to be exhibited hy the mouth and in enema (ibid., p. 931, Art. 
Spasms, § 31, 0). 

620. But the most remarkable cause of the slow progress of the ther- Sowp^otrSs 
ajpeutical science is to be found in the highest and most legitimate ranks ^fj^g^f^re^me' 
of the medical profession — in the physicians themselves (§ 9) ; in wrong dies, and of 
estimates of the efficacy of particular medicines and agents (§ Y, D) ; in Sere^."^^"^^ 
erroneous, limited, or one-sided views of the causes, seats, nature and 
procession of diseases ; of medical doctrine (§ 4, 1.) ; medical jealousies and 
contentions ; opposing systems ; plans on means of cure ; jarring views 
as to the efficacy or operation of certain medicines ; opposite opinions 
in courts of justice, or otherwise appearing in public ; the publicity 
given to medical discussions have an unfavorable influence on the pub- 
lic, and prevent many from trusting to medical treatment (ibid., pp. 
1130, 1131, Art. Therapeutics, § 12, I). 



621. The blood is found altered in disease : 

1. By a change in the proportion of its constituent elements; 

2. By the addition of foreign matters (+) (cf. G. Harvey). 



How the 

Mood be- 
comes im- 
pure. 



AN HONEST PEOFESSOR. 



Maex, K. Z., M. D. Professor in the University of Gcettingen. 
eral Pathology. Gmttingen^ 1833. 



Gen- 



622. The conscientious practitioner can resort but to few remedies ; 
for whenever the choice lies between what is harmless and what " heroic," 
he must unconditionally employ the former (Preface). 



Materia 
medlca. 



Chomel, M,,M. D., Clinical Lectures on Typhoid Fever. Paris^ 1834. 
See Beit. ajst> For. Med. Rev., 1836, Vol. 11. 

623. In the stools of patients^ at the commencement of recovery from Typhoid 

typhoid fever, there are always scyhalcB; on which stools oFcon- 

Dr. John Conolly observes : If medicine had produced the same arwlys^^con- 

effect earlier, which nature did eventually, the symptoms would have tainscy&a/a. 
been milder, although the course of the disease would not have been cut 
short (Rev., p. 40). 

" The course of the disease would not have been cut short " may admit of a " perhaps." 



Laeiojec, R. T. H., M. D., a Treatise on Disease of the Chest. Trans- 



lated by John Forbes, M. D. 



London, 1834. 



624. I would therefore lay it down as a valuable practical rule in 
chronic affections of the heart, that previously to having recourse to any 
remedies intended to act directly on it, we ought to be assured that the 
digestive organs are in a healthy state, that their mucous surfaces are 



Chronic 

heart-dis- 

etise. 

The first step 

to be taken; 

purgation. 



10 



146 



THE DOCTRINE OF PURGATION. 



free from irritatimi^ their vascular system not morbidly distended^ and 
that the liver is performing its secreting function freely and regularly 

(p. 687). 

Let Brandreth's Pills be used in accordance with the printed directions, and there will 
be no medicines required to " act directly on the heart." The mucous coats will be freed from 
all irritating substances, when the liver and the heart will, as a rule, perform their functions 
freely and regularly. 

Clark, Jajmes, M. J)., A Treatise on Pulmonary Consumption^ and In- 
quiry into Causes^ Nature^ Prevention^ and Treatment of Tuber- 
Gidous aud Scrofulous Diseases in General. London^ 1835. See 
Bkit. and Fok. Med. Eev., 1835. 



Cacheicia- ^25. Dysjpcjpsia is the most fertile source of cachexia in every form ; 
^om^<Jyspep- it also generates in derangement of the various secretory and excretory 
ranged secre- fuuctlons, particularly that condition of them in which the effete mat- 
ter is imperfectly carried off (p. 223). 



tion and ex 
cretion 



Consump- 
tion. 
Keep the sys- 
tem free from 
impur'ties, 
and you keep 
oS the causes 

of the dis- 



626. So long as the constitution remains unimpaired, the ordinary 
exciting causes (catarrhs, inflammations) may come into active play 
again and again, during a v^hole lifetime, without producing consump- 
tion ; but the moment the tone of the system is seriously lowered hy 
sedentary habits^ insufficiency of food ^ impaired digestion^ depression of 
mind., excessive study ^ vitiated atmosphere^ a very slight external cause 
will then sufiice to induce the deposit of tuberculous matter (Rev., pp. 
Tl, T2, vol. II.) 



CoNOLLT, John, M. D., Editor of the British and Foreign Medical 
Review, On ClarWs Treatise on Consumption. 1835, Vol. XXI. 

Consump- ^^^' Consumption is invariably the consequence of a pre-existing ^m- 
tion always hcdlthy statc of the constitution^ without which the accidental causes 
ti^r in^Se which Call it into being would have been entirely incapable of producing 

system. -^ ^j^^^^ ^^ ^1). 



CURE OF COl^SUMPTION AI^D DYSPEPSIA. 

'•Hammonton, K J., May 7, 1866. 
**Dr. Brandreth — Dear Sir : I have long wanted to write to you and express my grati- 
tude for the beneficial effects that have been experienced in my own family, and in hun- 
dreds, aye, thousands of others, by the use of Brandreth's Pills. The first year my lamented 
friend Brockway sold your pills in Boston (1838) I called at his ofiice. I was then in a de- 
clining state of health, and my friends, as well as myself, supposed my earthly voyage would 
soon terminate. Mr. Brockway urged me to take the Brandreth Pills, but having used so 
much medicine, with no good effect, I was more inclined to let nature take its course, and 
calmly submit to my fate. Mr, B. offered to give me one dozen boxes if I would try them 
as prescribed. By this I saw he had great faith in them, and I finally consented to take 
them, but not as a gift. I went home and went at it, almost hopelessly. After taking one 
box I began to feel better. Well, sir, when I had used up my twelve boxes, I was apparently 
a well, healthy man, my weight having gone from 131 pounds up to 152 pounds. I then 
ordered a supply, and between that time and the present I have retailed three thousand dol- 
lars worth of these invaluable pills, and am quite sure that I have thereby been instrumental 
in saving, not hundreds, but thousands of lives. I have given them to my oxen, horses, 
pigs, fowls, cats, dogs, and always with the desired effect. I have a wife and nine children, 
most of them born since I have used the pills. A more healthy family cannot be found 



THE DOCTRINE OF PURGATION. 



147 



We are frequently asked how it is our children look so healthy. My wife replies that * We 
raise them on Brandreth's Tills.' Now, my children overload their stomachs, get cold and 
out of order, like others, but they have been taught the remedy, and go and take the pills 
of their own accord. This I consider an important branch of their education, and feel as- 
sured, as they shove off upon the voyage of life, that they know how to take care of them- 
selves. I was in trade at my last residence, North Lincoln, Me., for 29 years, I have been 
here about seven years ; I am, therefore, Avell known, and my statements can be verified by 
hundreds. " Yours, 

"C. J. FAY." 



CONTAGION EVEN HARMLESS TO THOSE WHO USE BRANDEETH'S PILLS. 

Each one of us, even the most diseased, has within him a germ or root of that original 
pure blood of our common mother Eve, 

This germ of pure blood supports his life, and constantly struggles to throw out from 
the circulation corrupt humors into the bowels. Brandreth's Pills assist this regenerating 
process. 

By their powerful aid we constantly make blood of a better quality, until the whole is 
renewed and purified. 

Those who desire to pass untouched by contagious maladies, who wish for soundness of 
body and mind, or to have healthful children, should use Brandreth's Pills, which cleanse the 
bowels and the blood of all unhealthy accumulations. 



Combe, Andkew, M. D. Principles of Physiology applied to Preserve 
ation of Healthy (&e. Edinburgh^ 1835. Letter on the Ohservation 
of Nature in the Treatment of Disease. See Brit. & For. Med. 
Eev., 1855, Vol. XXL 

628. Experience shows that the physician and the remedy are usefid 
onl/y when they act in accordance with the laws of the constitution and 
the intentions of nature. . . If this be done systematically, every 
effort of nature will be towards the restoration of health ; and all that 
she demands from us in addition, is to remove impediments and facili- 
tate her acts (Rev. p. 509, sq.) 



Assist nature 

to remove 
impedimeQts 



629. Instead, therefore, of medicine being superseded, as many sup- 
pose, by taking nature for our guide, it will, on the contrary, only begin 
to take just rank as a science when our allegiance to nature shall become 
practical, enlightened, and complete. . . Nature is truly the agent in 
the cure of disease ^ and as she acts in accordance w\\h. fixed and invari- 
able laws, the aim of the physician ought always to be to facilitate her 
efforts, by acting in harmony with, and not in opposition to, those laws 
(ibid.). 

Dr. Combe in 1840 was in New Haven, Conn. We had a conversation with him on the 

freat importance of purgation as a universal remedy. But the doctor could not understand 
ow purgation could be useful after the bowels were emptied of their contents. How long 
a principle is uncomprehended ! and yet this great man might have lived thirty years 
longer, had he but have only investigated this one of purgation, and been governed by the 
lights of experience which he would have found to flow from it. 

Forbes, John, M. D., Editor of the British and Foreign Medical 
Keview, commencing 1835. 

630. Purgation appears to be banished (in continental treatment of 
fevers ), from a fear that it may increase the irritation of the follicles of 



Medicine 

and the 

" vis medica- 

trix naturae-' 



F&oer. 



1-J8 THE DOCTRINE OE PURGATION. 

ff*'*''''"/*^"* tlie intestines — a fear wliicli lias sprung from too excessive devotion to 

cretse"'intes- uiorbid anatomj. That active purgatives, particularly in the early 

Soi"""""" stages of fever, will increase the follicular irritation, is a completeh/ theo- 

Praefice' ^v^^c^^Z ohjection. The reasoning on which it is founded will not bear 

vs. examination, and our experience in this country experimentally contra- 

^^''^- diets it (Kev. 1836, Vol. III., p. 63). 

The Doctor is a friend of Brandreth's Pills. 

Leeches, 631. Li the treatment oi fevers we have witnessed more misery and 

a^costiyi waste of life from leeches, gum water, and costive howels than from any 
degree of purgation (Rev. 1836, Yol. lY., p. 167). 



Dess. 



Poison i 



632. Physiological researches during the last thirty years have satis- 
destroy the factorily provcd that most if not all of the assents which exert such 

nervous fac- -. -^ , ^ , /'ni.tii 

uitij ihrough destructive energy on trie nervous system (as poisons) do it through the 
^^^uood. medium of the circulation, as shown by the experiments of Christison 
and Coindet, of Brodie, Vihorg, and others. And we are much mis- 
taken if future researches do not prove this equally of what we term 
the true puerperal fever. . . The entire absence of coagulum, the per- 
fect fluidity of the blood, apparently both in color and consistence to 
thin watery claret, tends to confirm these views (Rev. 1836, Yol. XL, p. 
484). 



The materia 



633. How many medicinal agents have been indebted for their rep- 
utation to fortuitous circumstances. It would be easy to show from the 
Ind ?u/r^of fo^i^^r history of diseases that the medicine employed in the treatment 
useless drugs had uo influence whatever in efiecting the cure, but that the result was 
dangerous entirely owing to the efforts of nature. A physician, for example, em- 
^p?actice.^ ploys a Certain medicine in a few cases and finds his patients recover ; 
hence he concludes that the treatment and the cure stand to one another 
in the relation of cause and eflect. Misapprehensions of this sort pro- 
duce a very false and injurious impression upon the minds of students, 
leading them in their future practice to bleeding, blistering, and treating 
" heroically " all affections that appear to be violent and intractable 
(Kev. 1842, Yol. XIII., p. 55). 

In twmors, &c., Braotdeeth's Pills affect fiestlt and chiefly the 

MORBID GROWTH. 



Tumors. 634. " Naturc gives up in the first instance that which is extraneous 

^on^w'*J^' and parasitical, in preference to what is normal hoth in structure and in 

pSlsrS^e ^^W^^^ ^f development. '''' This is an important law, observable in a. 

<miy impijr thousand cases, without the auspicious operation of which indeed one- 

TitAts. ^^^ ^£ ^^^ labors would be in vain (ibid., pp. 330, 331). 



Acute rhevr (335, Thcse recommeudatious {continued purging in acute rhewtna- 
tism) are in the highest degree important /br the speedy removal of the 
disease, whether mild or severe : and the custom of some practitioners 



THE DOCTRINE OF PURGATION. 149 

who avoid purging from rear of giving occasion to injurious exposure The only 
of the person, cannot be too strongly reprobated (ibid., p. 450). ^gS,i^.^^' 

636. It is evident then : The resume 

1 . That in a large proportion of the cases treated by allopathic phy- art, ™atire, 
sicians, the disease is cured by nature and not by them. ***'• 

2. That in a lesser, but still not a small portion, the disease is cured 
by nature, in spite of them ; in other words, their interference opposing 
instead of assisting the cure. 

3. That consequently, in a considerable proportion of diseases, it mJrkflpJiy 
would fare as well or better with patients, in the actual condition of the ^^^^ '''^^' 
medical art, as more generally ^ractised^ if all remedies, at least all up' 5^t£ 
active remedies, especially drugs, were abandoned (p. 257, vol. XXI., " a^"/»"^ 
1846). 

63T. This lamentable condition of medicine, regarded as a practical mstoryof 
art, is in truth a fact of such magnitude — one so palpably evident — that ^d'^what'it 
it was impossible for any careful reader of the history of medicine, or teaches. 
any long observer of the process of disease, not to be aware of it. What 
indeed is the history of medicine but a history of perpetual changes 
in the opinions and practice of its professors, respecting the very same 
subjects — the nature and treatment of diseases ? And amid all these 
changes, often extreme and directly opposed to one another, do we not 
find these very diseases, the subject of them, remaining, with some ex- 
ceptions, still the same in their progress and general event ? (pp. 257, 
258.) 



638. To be satisfied on this point we need only refer to the history . . 
of any one or two of our principal diseases or principal remedies, as ^er^%— 
fever^ pneumonia, syphilis — antimony, hlood-letting, mercury. Each of *^doubSS?r 

these remedies has been, at difierent times, regarded as almost specific *^ther^?^S 
in the cure of the first two diseases, while at other times they have been rious. 
rejected as useless or injurious. What seemed once so unquestionably, 
so demonstrably trne, as that venesection was indispensable for the cure 
of pneumonia ? And what is the conclusion now deduced from the 
clinical researches of Louis and others ? Is it not that patients recover 
as well, or nearly as well, without it ? The experiments prove, far better 
without it (pp. 258, 259). 

639. If the medical god Mercury has lost the domain of syphilis, he Mercury— 
has gained that of inflammation ; and many of our best practitioners jjf/^^|°tu?e 
might possibly be startled and shocked at the supposition that their sue- questionable. 
cessors should renounce allegiance to him in the latter domain, as they 
themselves had done in the former. And yet such a result is more than 
probable, seeing that there exists not a shadow of more positive proof, 

if so much, of the efficiency of the medicine in the latter than in the 
former case (p. 259). 

640. Truth is good. If the art of medicine, as we profess and Truth above 
practice it, cannot bear investigation, and shrinks before the light of *^^ 
truth, from whatsoever quarter it may come, it is high time that it 



150 



THE DOCTRINE OF PURGATION. 



should cease to be sanctioned and upheld by philosophers and honest 
men (ibid). 



Dr. Forbes deserves well of all mankind. 



Louis, Ch. a., M. D., Physician to the Hopital de la PitiL Pecherches 
SU7' les effets de la saignee dans quelques maladies inflammatoires^ 
c&G. On the Effects of Bleeding in Inflammatory Diseases. Parisy 
1835. 

64:1. A volume consisting of numerous cases to test the efficacy of 
pr^^Sf to be hlood-leiting in pneumony at the Hospital de la Pitie, in Paris. Some 
uSsii^Sr- patients were bled on thetirst, some on the second, some on the third day 
jiammatio?i of thc attack, and so on ; some seldom, others repeatedly, with the periods 
e lings. ^^^^^^ attack to convalesccnce duly noted. And from these cases he 
comes to the inevitable conclusion that hleeding is a noxious, not a hene- 
ficial agent, in the disease — that it does not remove jpain^ and if it at 
all modifies it, in twentyfour hours it is generally as severe as ever ; that 
bleeding seems to produce an effect only when used at a period suffi- 
ciently remote from the origin of the malady to be perhaps coincident 
with improvement. 

equally use 642. Mr. Louis applied to the effects of llisters the same experimen- 

tal analysis, and came to the conclusion that in pneumonia they are 
also devoid of uUlity. 



Brandreth's Pills are of absolutely certain benefit in every case of pleurisy ; and in all 
inflammations whatsoever they should be used at once. Then they have never been known 
to fail. 



LOTJIS, E. H. 

1835. 



M. D., Pathological Researches in Phthisin. London, 



on?ytrueev^ ' ^^^- The numerical methodic, in fact, the only method in our power 

TirtSe *^of*^^ ^^ pursue ; it is the only control we can possess over as-^ertion, the only 

medicine. tcst for opiniou. Its application to a sufficient number of facts, must 

inevitably give us the most exact and best possible knowledge of those 

facts, and we .would ask the individual who believes that science is 

founded on facts, what more he would require ? (p. 28.) 

By the numerical method we would be judged. Let this method be applied to effects 
Brandreth's Pills produce upon disease; and what an amount of suffering and sorrow would 
soon terminate ! No inflammation, no cholera, no fever, no pleurisy, no rheumatism, or any 
pain Vi^ould cause alarm, because it would be known that a few Brandreth's Pills would soon 
restore any and every organ to health. 



MooEE, G., Surg., An Inquiry into the Pathology, Causes and Treat- 
ment of Puerperal Fever; which obtained the Fotheegilliait Gold 
Medal, March, 1835. London, 1836. 

Puerperal 64:4. Pucvperal Fever. — That early purgation is indeed an essential 
pITrgSn.^^"^ auxiliary in the treatment, is amply testified by those who have been 
most successful (p. 223). 



THE DOCTRINE OF PURGATION. 



151 



In every case of puerperal fever I have seen, where purgation was u?ed at once when 
the violent pain in the womb admonished that inflammation had commenced, was cured. 
The purgative was Brandreth's Pills. Every other case where other remedies than purga- 
tive were applied was lost. In fact, forty years ago it was generally understood that puer- 
peral fever meant — death. In 1840 a friend of mine, a physician, lost seventeen cases of 
this fever one after another. I recommended purgation, i. e. Brandreth's Pills. He followed 
my plan and gave the pills, and never after lost a case. 

Pakise, M. K., M. D. Pathology of Rheumatism. See Bulletin" 
General de Therapeutique, July, 1835, and Bjbit. and For. Med. 
Key., 1836, Vol. L 

645. Bheumatism. — Its change of situation does not change its na- 
ture, although it goes by different names. Thus it is the same disease 
which in the head is called gravedo, in the neck torticollis {wry-neck), in 
the side pleurodynia, in the loins lumbago, and along the sciatic nerve 

sciatica (Kev., p. 255). 

CURE OF INFLAMMATORY RHEUMATISM. 

Dr. Brandreth : Sing Sing, Jan. 25, 1867. 

For some years I have been subject to attacks of inflammatory rheumatism, which usually 
come on every three or four months. My physicians were of the highest reputation. By 
their advice 1 took colchicum, citric acid, and other celebrated remedies, but none relieved 
me or shortened the attacks, which lasted for weeks at a time. In my last attack I con- 
cluded to try 3^our famous pills. I was lying upon my bed at the time, suffering the severest 
pains in my feet and ankles, which no pen can describe. 

The first dose of six pills was so effective that in a few hours the pain and swelling sen- 
sibly abated, and in forty -eight hours were all gone, and I was cured and have had no 
return. 

I send you this testimonial for the benefit of others who, suffering in a similar manner, 
may know how they can find certain relief. 

I am respectfully yours, J. D. DUDLEY. 



Rheuma- 
tism. 
The same dis' 
ease under 
various 
names 
according tcr 
location. 



FURTHER PROOF. 



To Dr. Brandreth; 



Brooklyn, Oct. 5, 1866. 



It gives me pleasure to state the good I have experienced from your pills. Since I com- 
menced their use I have felt in all respects like a new man, and the rheumatism I took them 
to relieve has entirely disappeared. At first I was prejudiced against them, because their 
operation was attended with severe griping; but on a further experience I am convinced 
such pains were only caused by the medicine struggling with and removing certain obstruc- 
tions in the bowels. I commenced with taking five pills every night on going to bed, and 
by an increase of one pill every evening ran the quantity up to twelve pills, which number 
I continued to take for ten days, and then gradually reduced t(» five pills at a dose. "With 
the exception of the first three doses I have experienced no pain or griping, but the opera- 
tion was both easy and pleasant. I took the pills for twenty-four days, and noticed that I 
passed a great quantity of black, bilious-looking, offensive matter, which I am glad to have 
got clear of. The Brandreth Pills take right hold of all that is deleterious in the bowels ; 
and, as I said before, I now feel like a new man, and deem it my duty to express my grati- 
tude to you. Sincerely your friend, 

FRANKLIN L. HAWLEY, 238 Classon Avenue. 

McIlwain, George, Surg., Remarks on the Unity of the Body, dso. 
Lmdon, 1836. Bee Skit, and Foe. Med. Eev., 1836, Vol. 11. 



^^^. The whole of the hody sympathizes with all its jparts (Rev., p. 
loOj, 



15-2 THE DOCTRINE OF PURGATION. 



"VYiLLLAjvis, Robert, M. D., Physician to St. Thomas Hosjpital. Elements 
of Medichw. London, 1836. 



Astheimpu- i^^^^ ^ Certain cliseases — 2i^ typhus, scarlatina, variolic erysipelas. &c., 

nty, so the -,.-,. ^-^ ^ni ^ \ ii ' ' ^. r» • ' 

disease, are produced by morb id poisons. Ihese nave dennite specinc actions — 
ofVemfia- latent periodicity — the phenomena varying accordmg to the dose and 
upon^^Kl- predisposition of the individuaL Generally these poisons act with an 
^'uriifo-ihl iiitensity proportioned to the feebleness of the patient (Preface). 

blooJ. 

Bleeding 648. Bleeding. — From a careful comparison of such evidenc^e as 

*^movr[hr Grists, Dr. Williams concludes, that since the evidence against bleeding 
cause of dis- in fevor so greatly outweighs that in its favor, it seems demonstrated, 
^^Icaifet^-' ' and by the most practical experience as yet before the public on any 
fe<er, etc. (^jgpoged modical question, that bleeding in the cure of fever is the ex- 
ception, not the rule / . . that the cause of the disease being a poison, it 
is necessary to remove the poison from the body in order to stop the dis- 
• ease (p. 171). 

The benefit ., 649. The most effective treatment was found to be as follows : 

and^wyec- Ten grains of rhubarb, or a scruple, at whatever stage the patient 

twns. ^^g admitted, and barley-water enemas, night and morning, with half 

an ounce of syrup of poppies added. Success is the only criterion in 

medicine, and certainly this practice has effected the cure of a much 

larger proportion of cases than any other mode I have witnessed (p. 93). 

How infinitely superior Brandreth's Pills are to this treatment, as all who know them 
will admit. 

fIatfet%JS- ^^^' ^^^ results obtained by the practice of bleeding in scarlet fever, 
proved to be as woll as by abstracting from it, are given in the following table : 
bySc^s^. Of 121 persons, treated in the Foundling Hospital, in 1786, by bleed- 

ing, 19 died, being about one in six. 

Of 60 persons, treated at the London Fever Hospital in 1829, by 
bleeding, 10 died, being the same average ; whilst 

Of 125 persons, treated by purgatives and emetics, only 10 died. 

And if Brandreth's Pills had been the purgative, not five out of a hundred would have 
died. 



Lawkence, William, Surg., Treatise on Hernia. London, 1 838. 

strcmguJa- 651. Strangulated LLernia. — The notions that purgatives are capable 
^Purgatit'eH of cxcitiug the mucous membrane of the alimentary passages, and thus 
fwi'^nmt' pi*oducing an aggravating inflammation of the stomach and bowels, is 
mjm'e. groundlcss ; and the practical precepts founded on this theoretical and 
imaginary foundation, have always appeared to me a signal triumph of 
doctrine over the most unequivocal results of experience and the plain- 
est dictates of common sense (p. 323). 

If the bowels should not be relieved three or four hours after the 
operation, a pill of calomel, or of calomel and extract of colocynth, may 



THE DOCTiiiNE OF PURGATION. 153 

be given, followed by a drachm or two of sulphate of magnesia in mint 
or plain water, and this repeated every three or four hours until the 
'bowels are freely relieved. If this do not succeed, a large common 
injection, with four or six ounces of infusion of senna, or an ounce of 
castor-oil, should be administered (ibid.) 

Give six or eight Brandreth's Pills ; they will certainly relieve the bowels, and if given 
early will probably save the pain and danger of the operation. 

Kennedy, Henry, Surg., Editor Dublin Medical Press. Sept. 23, 1840. 

652. As soon as a quamiitfy of blood is abstracted.^ that moment the Nature ad- 
system commences to supply the deficiency. So impatient is nature at the ^ettLrj--^'- 
loss, that if the food taken is insufficient for her purpose, she takes back ^^^fj,^^ j^: 
whatever may have previously been poured out — such as serum, lymph, purities, it 
or possibly even pus. (Cases in proof are given from Drs. McDowell^ them'^t^the 
Btoher, and by the author.) circulation. . 

Never bleed. " Thou shalt not kill." 

MoKGAN, G. F., M. A. First Principles of Surgery. London, 1840. 

653. The influence of the blood on the vital functions is proved by ^^^^j ^lood 
the fact that the vigor and activity of animal life depend principally on ^^^^\ *«■ 
the condition of the circulating fluid ; and according to the qualities of covery from 
the mass, when inflammation sets in after severe injuries, are the subse- *^^^*^®°'^- 
quent constitutional phenomena in a great measure regulated (p. 179 +). 

664. There are two principal morbid varieties of constitution in Morhid 
which local injuries produce peculiar and extraordinary efiects. The \iood ° from 
one is that of general plethora, attributable to over-repletion of the vas- *^° *^^"^^®' 
cular system ; the other arises from an impoverished state of the blood, 
coupled, in the worst cases, with a disturbed condition of the nervous 
system (p. 144). 

655. Nothing at the commencement (of inflammation) will suffice ivflamma- 

but free and general depletion with purgatives / and we have by these PrTe'and 

means known consciousness restored after an unfavorable proe^nosis had Q'^'^fraipur- 
^ rfe^ gallon re- 

been passed (p. 147). quired. 



656. If we regard the morbid alterations in the composition of the Fevers 
blood as the primary source of fevers, we can easily explain the subse- ^secretions 
quent derangement in the functions of the organs, and the vitiation of ^^""^joodT^ 
the different secretions during their continuance. In all cases the in- 
creased discharge has the effect of relieving the congested state of the 
mucous membrane (p. 179 +). 

The believer in the efficacy ©f purgatives will thank Dr. Morgan for this testimony. 



154 



THE DOCTRINE OF PURGATION. 



Canstadt, Chaeles, M. D., Professor in the JJniversiPu of Erlangen. 
Special Pathology and Therapeutics founded on Chnical Observa- 
tions. Erlangen. 1841. See Brit. & For. Med. Key., 1842, 
Vol. XIIL 



jorftrae— its 657. The modus operandi of iodine consists in tmderTnining the uni- 



action. 



versal process of nutrition (vol. L, p. 11 — Eev., p. 331). 



Asthetlood, 
so the nerv- 
ous system. 



658. An asthenic condition of the nervous system is an affection 
always coincident with anemia i since, on the one hand, a normal con- 
dition of that system is indispensable to a right formation of the blood, 
as on the other normal blood is essential to a healthy state of the nervous 
system (ibid., p. 33— Eev., p. 332). 



Blood and 

pus. 



659. Severe suppuration produces precisely the same effects as ex- 
cessive venesection • while precisely the same means which improve the 
condition of the blood produce a similar effect on that of the pus (ibid., 
p. 87— Eev., p. 336). 



Jnjla/mma- 

tion. 
Nature's at- 
tempt to cure 
— she may 
overdo it. 



660. The phenomena of inflammation are not m^orhid movements^ 
but consist chiefly of energetic endeavors of nature to oppose or rid her- 
self of an injurioris agent or ivflmence. Death may in this way inci- 
dentally occur from salutary efforts of nature herself, as when hemor- 
rhagic apoplexy of the brain or lungs ensues from the reaction instituted 
to repel or extrude some morbific agent or influence operating on these 
organs or elsewhere (ibid., p. 96 — Eev., p. 337). 



Mercury — 
producing 
salivation — 
no medicine 
but a poison 
aggravating 
the inflam- 
mation. 



661. Dr. Alison of Edinburgh (Library of Medicine) denies " that 
mercury administered so as to affect the gums possesses any power of 
controlling inflammation and its consequences." And on this point the 
present writer, after considerable experience, reiterates an opinion he 
formerly expressed, that he has more frequently seen inflammatory 
symptoms aggravated or transferred to other parts^ on that event {saliva- 
tion) taking place .^ than relieved by it (ibid., p. 3 — Eev., 338). 



Crisis— &^. 662. The discharges [sweats) which occasionally signalize the crisis 
other view. ^^ ^^^ coutain the materia peccans. The crisis itself is the recovery, the 
discharges being nothing but the effects and proof of the regeneration 
of the unhealthy functions (ibid., p. 260 — Eev., p. 342). 



Hypertro- 
phy. 



663. Hypertrophy. — Blood-letting.^ if practised in moderation.^ is apt 
to ^voYQ fruitless ^ if energetically em^lojed, it is more likely to ^r^)- 
Bieeding in- motc anemda^ dropsy, and debility than to cure hypertrophy (ibid., p. 10 
jurious. _i^ev., p. 331). 



Chlorosis 
of all forms 
from imper- 



664. The multifarious symptoms of chlorosis do not require separate 
attention ; since, depending on a common lesion, to wit, the deficient 



THE DOCTKINE OF PURGATION. 



155 



erasis"^ of Hood, they simultaneously disappear when that fluid is brought fectiy eiabo- 
to its normal state (ibid., p. 40 ; Kev. p. 333). 

HuENEFELDT, F. L., M. D., Chemistry and Medicine m Close Co-operation. 
Berlin, 1841. 

665. In the coBCum there is carried on to a certain extent a repetition Digestion 
of what takes place in the stomach and small intestines. In the colon X^'^^cunlr 
are found the insoluble matters of the food, the bronze coloring matter 

of the bile, mucous, fat, soluble and insoluble salts, various azotized 
matters, etc., besides fetid volatile productions (p. 110). 

These matters being retained and reabsorbed through constipation, what an amount of 
eyil is produced ! Let those who are costive beware. The bowels must be evacuated once 
at least in the day, or there can be no health and no safety. 

MmsnsTELEY, Thomas, Surg. A Treatise on the Nature^ CoAise am.d Treat- 
rnent of JErysipelas. London, 1^4:1. 

666. It is an easy thing for the purpose of producing an immediate 
effect, or " knocking the disease on the head," as it is often termed, to 
take from a man two, three or four pounds of blood ; but should he sur- 
vive, the probability is that he will not for several years, if forever, 
he the sound man he was before the shock his system has had inflicted 
upon it by such heroic proceedings (p. 220). 

^%^. Purgatives, in by far the majority of cases, if properly used, ^^v^p^^f^^- 
completely obviate the necessity of venesection, especially if they have Bloodletting 

J- %/ t/e/ /Xt/«/ and. T)iLTnci~ 

been preceded by an emetic (p. 230). 



and 'purga- 
tion com- 



pared. 



This is sound doctrine. 



Ceichton, Sir Alexaitdee, M. D., Commentaries on some Doctrines of 
a Dangerous Tendency in Medicine, and on the General Principles 
of safe Practice. London, 1842. Bee Brit, and For. Med. Rev., 
1843, Vol, XV. 

668. Ln typhus, bleeding is useless and reprehensible. J^ature's prin- 
ciple of curing this disease is the same as that by which the paroxysm 
of an intermittent is terminated ; she reduces the quantity of circulating 
fluids until she brings about an equilibrium between them and the en- 
feebled moving powers by excrementitious evacuations (Rev., p. 465). 



TypJius. 

Bleeding 
useless. 

Nature's 
cure — 

another 
view. 



669. The Liebig theory of the action of contagious and other animal sypJiius. 

poisons is, that if the exciting agent be a compound body, it will repro- cm-e without 

duce itself ad infinitum, provided the compound body on which it acts — me?eTy*by 

contains elements fitted for such an end. This theory accounts for nu- ^"^^'**^'''^- 

merous cures of syphilis without mercury by Dr. Friche in the hospital ^^Ae^^O*'^ 
of Hamburg. From low diet and continued purgation the parts of the 

* Blood globules. Brandreth's Pills not only take away impurities, but they make the 
blood richer in Crassamentum or blood globules. 



156 THE DOCTRINE OE PURGATION. 

blood are not supplied wliicli are susceptible of the metamorphosis. 
Thus the poison hecome^ starved mid purged out ^ the same result being 
produced as is eitected in lever, by the annihilation of the desire for 
food and consequent suspension of the process of chymification (con- 
densed from pp. 210 to ult. of Crichton). 

Gully, James M., M. D., On the Simple Treatment of Diseases. Lon- 
don, 1842. 

Nature's 670. The constant tendency of the diseased hody is towards cure, and 

"— ItSther this for the most part by the erection of certain modes of vital action in 



new. 



other parts of the frame than that which is morbid, and by the elimina- 
tion of certain matters from the emunctories. . . Thus a fever usually 
declines just as the kidneys, the lower bowels, or the skin pour out their 
respective excretions copiously (p. 32). 

These " certain matters " have been obtained from morbid parts invariably. 

Jones, Heney Beale, M. D., On Gravel, Calculus, and Gout, chiefiy 
an Application of Professor Liebig's Philosophy to the Preven- 
tion and Cure of Diseases. London, 1842. 

G(yat- 671. We may diminish the proportion of the gouty material in the 

1. By stopping the supply — that is, by change of diet ; and 

2. By causing an increase of secretion from the liver and intestinal 
glands through the action of purgatives. 

These medicines will have the further eifect of causing the secreted 
products to be discharged from the intestinal canal, instead of remaining 
to undergo partial reabsorption (pp. T'O to 74). 

Laj^^-za, Y., M. D., Professor of Physic in the University of Naples. 
Positive Nosology. Naples, 1842. Bee British and ]For. Med. 
Eev., 1846, Vol. XXIIL 

What retards 672. The chief obstacles which impede the advance of experimental 
knowiedgria mediciue are the following : 
medicine. |_ ^\^q extreme variety which prevails in different countries in plans 

of cure, popular remedies, medical usages, &c., whereby all common 
grounds of comparison are wamting. 

2. The monster-abuse of polypharmacy — ^the injury it has caused, 
alike to humanity and to " the art," being notorious. 

3. The number of com^pound remedies still in vogue, a clear relic of 
barbaHsm^ which should long ago have been banished by the profes- 
sion. 

Leaving all these behind, medicine must commence anew to determine 
the true power and value of remedies (Rev., p. 63). 

^ETH^^f 673. We first find that therapeutics must hQ founded on experience. . . 

S"e*d '^•^^ method of treatment to be adopted in any particular case must be 



THE DOCTRINE OF PURGATION. 157 

that which has most frequently been found effectual in some previous 
and analogous case (Rev., p. 15). 

MacLeod, Radcliffe, M. D., Physician to St. George^ s Hospital. On 
Eheumatism. in its Various Forms. London, 1842. 

674. Acute Rheumatism. — Purgati^i^es. — This discipline ought gen- Acvterhm' 
erally to be repeated on several successive days • indeed, throughout the '^"'^^^^^ 
whole course of a case of acute rheumatism, the due evacuation of the purgation 
bowels ought to be an indication never lost sight of ; and in many cases, t^e only de- 
where the attack is comparatively mild, this is the only form of deple- qiSred. 
tion required (p. 34). 

RicHTER, C. A. W., M. D., Contributions to Scientific Medicine. Leip- 
zig, 1842. 

Important Article. 

675. The Yis Medic ateix Nature. — This power both organizes un- vis memca- 
organized matter, and disorganizes vitalized matters, separating vitalized ^^^' 
matter from, the system, after it has fulfilled its uses in the orga/nism, and ^^^^^^^^^ 
has become, if detained, a hurtful agent (sect. 1). effete matter 

the system. 

676. If the recomposing and decomposing processes are in equi- Nature'sway 
librium, there is health ; but if the effete matter be not cast off, or a removLgim^ 
hurtful agent enters the system from without, the equilibrium is de- the"syltem.°^ 
stroyed, and the innate vital force sets up an action to restore it — the re- 
sidtlng phenomena being the phenomena of disease. So that morbid 

action consists in an interruption of the renewing or 7'eformative pro- 
cess, concurrently with alterations in the quality of the blood, and a 
reaction of the innate vital force to restore the normal state (ibid.) 

f)77. The hurtful agent is eliminated from the system through the Localization 

secreting and excreting organs, or not being fully eliminated, is localized Jj^s^^clus^e^ 

in some one or more special structures, thus giving rise to various con- locai ais- 
stitutional and chronic local diseases (ibid.) 



ture's efifort 
at a cure ; — 



678. Fever is a healthy process. The innate vital force, feeling the Fevers 
presence of a hurtful agent in the system, attempts its removal after the 
sayne manner as it removes effete matter. If the hurtful agent is not elim- ^^g^ ^^^^ 
inated, it is localized in an organ, and the innate vital force attempts its 
removal by colliquation of that organ, giving rise to various changes of 
structure, and to the general symptoms of local diseases. 

Hectic fever is in reality a healing process, set up to expel the hurtful Hectic fever. 
power fro'm. the organ to which it has retreated '^ and it is injurious only 
because the hurtful power is of such a nature, or so situated, as to re- 
quire for its expulsion a greater effort than the vital machinery will bear ; 
so that the recomposing process is never re-established, and the colliqua- 
tion goes on until the dissolution of the organism, or death, takes place 
(sect. ii). 



158 



THE DCKTIKINE OF PTIRGATION. 



How medi- 
cines ought 
to actv 



679. Medicines ordy asswiing the healthy action of nature in throw- 
ing off the hurtful power (ibid.) 

And this is what Bran dreth's Pills produce. No more: no less. 



ScHULTZ, C. H., M. D., Professor in the University of Berlin. On the 
Benewal of Human I^fe. Berlin^ 1842. /&^Bkit. and Foe. Med. 
Kev., 1845, Vol. XYIIL 



The blood- 
its develop- 
ment. 



Chlorosis 

and 
phthisis. 



680. It is necessary that the organic constitnents of the blood pass 
through their embryo state, jnst as the embryo itself, before they can be 
perfectly developed ; and as the lymphatic glands are the gills and pla- 
centae of the system, if these perform their functions imperfectly, as in 
scrofulous constitutions, a deposit from the unripe blood takes place. 
Hence the development of chlorosis and phthisis (p. 142; Eev., p. 392). 



Blood— im- 
purities and 
varieties of 
diseases. 



Elemsnts o 
Foe. 



General Pathology. Berlin^ 1844-45. See Beit, and 



ED. He v., ibid. 



681. The state of the blood (circulating through the secreting organs 
influences their diseases. (Predispositions in the glandular and secreting 
systems.) (Rev., p. 345.) 

By a stoppage of the depurative process in the liver the whole mass 
of the hlood gets charged with impurities. The dead vesicles show a 
tendency even to chemical decomposition, as in stinking secretions, nau- 
seous cutaneous affections, &c. . . The blood acts injuriously on the 
nervous and muscular system ; it is deficient in the stimulating property 
of healthy blood. Thus the brain, nerves of the senses, and muscles, 
are imperfectly acted on, are weakened, and at last paralyzed. Apoplexy, 
intermittent fever, spectral illusions, and even paralysis of the senses, 
are the result of this state. (Predispositions of the blood.) (Rev., p. 
343.) 



Defective 
excretAon;— 

a frui ful 
source of dis- 
ease. 



Morbid mat- 
ters, etc., re- 
tained. 



Williams, Charles J. B., M. D., Principles of Medicine. London^ 
1843. See Beit. and. Foe. Med. Rev., 1844, Vol. XVII. 

682. The excretions are defective in many idiopathic and symptonl- 
aticy^'y^^^, and there can be little doubt that many of the constitutional 
effects of these fevers are, in a great measure, due to this important ele- 
ment. The positively noxious properties which excrementitAous matters 
retained in tJie hlood are known to possess^ must he tahen into- account^ 
when we attempt to explain the state of constitutional irritation and de- 
pression, with perversion of functions, which fevers so generally present. 
The changes in the hlood may also he in part referred to defective elimi- 
nation of eifete matter / and it is when the secreting organs recover their 



power ^ and a diarrhoea occurs^ or a copious discharge of highly-colored 
urine^ that these appearances cease (p. 81 ; Rev., p. 479). 



683. The causes of disease are changes in the due proportions of the 

Disease from ^ , ,. «/. ••iir>' 

changeintiie blood, and othcrwise, by respiration, secretion, nutrition, and by loreign 
^"'''- matters (ibid.) 



I 



THK DOCTRINE OF PURGATION. 



159 



684. In the treatment of this element of disesiiie— foreign morbid matter ^j 
in the hlood — the two indications which present themselves avQ^ first, to 
counteract the injurious operation of these matters / and second, to expel 
them from the system. We do not possess chemical antidotes which 

CAN ACT ON THE FOREIGN MATTER IN THE BLOOD WITHOUT INJURING THE 

BLOOD ITSELF. The othcv indication is more generally pursued, although 
little recognized by practitioners, to expel the offending matter from the 
system. The excretory organs, especially the hldneys and the alimentary 
canal, are the natural emunctories through which foreign and offending 
matters are expelled from the blood. Let us bear in mind how often 
fevers and other serious ailments seem to be carried off by spontaneous 
diarrhoea, diuresis, or perspiration (ibid., p. 122 ; Rev., p. 485). 



All chemical 
antidoten 

INJURE THE 
BLOOD, 

although they 

may expel 
morbid mat- 
ters from it. 
Expel these 
an nature 
does. 



Cozzi, L., Professor of Chymistry. Analysis of the Blood in a Case of 
Lead Colic, in Journal de Pharmacie. Paris, February, 1844. 
See Edinburgh Medical and Surgical Journal, 1844, Yol. LXII 

685. Professor Cozzi, in analyzing the blood of a person severely Painters' 
affected with lead colic, discovered that the lead existed in the state of a Poison ' of 
salt, or of an oxyde of the metal, in the albumen of the blood (Ed. ^^"^ wo?d.*^^ 
Journ., p. 553). 



Houston, John, 
1844. 



M. D., Introductory Lecture in Surgery. Dublin, 



The great mind of John Hunter saw and believed that the 
blood possessed in itself an independent life even while circulating 
loosely in the blood-vessels, but he knew not the nature and the seat of 
that vitality. The discovery was reserved for the physiologists of our 
days. There are particles, called globules, floating in this liquid, about 
the 3000th part of an inch in diameter, or so small that myriads of them 
are contained in a single drop. It has been ascertained respecting these 
globules that they are, each and all, endowed with a definite and uni- 
form shape, and with a development, in virtue of which they pass by 
successive transitions from a condition of origin to one of final evolu- 
tion — a veritable organization, in other words — properties which give 
them a claim to the title life, as much as those which justify the appli- 
cation of that term to the ovum, from which proud man himself dates 
his being. The atomic particles of which the blood is composed being 
thus individually alive, collectively they form a mass of which it may 
literally, as well as allegorically be said : " For it is the life of all flesh y 
the blood of it is for the life thereof ; for the life of the flesh is in the 
blood.''^ 

The globules are themselves, each and all, possessed of an independ- 
ent life. I have repeatedly w^atched them, and have shown them to 
others, when barst from their cell-membrane, performing sundry inde- 
pendent and apparently voluntary evolutions in the field of the micro- 
scope, until to the eye the whole looked like a moving mass of creeping 
things. In this view, then, the blood is doubly alive as exhibited — first 
in its forming and taking part in the repairs of the animal machine, and 



The Uood. 
Physiology. 



Bed corpus' 
cleH. 

Description 
of their indi- 
vidual vital- 
ity ; proved 

by micro- 
scopical ob- 
servation. 



The globules 
possessed of 
independent 
motion. 



natural out 
lets. 



Purae till 



160 THE DOCTRINE OF PURGATION. 

secondly, in the independent movements possessed by the ultimate par- 
ticles of its matter (Lancet, Amer. Edit. 1845, vol. I., p. 214, +). 

PrDDUcK, John, M. D., On the Treatment of Indolent and Irritable 
Ulcers. london^ 1844. See Lancet, 1841, Vol. II 

ucers— 687. I regard the ulcer as a natural outlet or issue for the escape of 

certain morbid jprinciples frmn the bloody the retention or suppression of 

which would have occasioned diseases of a more dangerous tendency. . . 

the discharge Jf the ulccr or tlic issuc emit a disgusting odor and discharge freely, the 

!^^hen^''they neccssity for such a drain is unequivocal ; it cannot be closed without 

h^" eS*"^^^ risk of a worse disorder. But when the odor of the ulcer, or the issue, 

ceases to be disagreeable, and the discharge is moderate in quantity, and 

of a healthy quality, it admits of cure with perfect safety (Lane, p. 

405). 

Baetlett, Elisha, M. D., Professor of Medicine in the University of 
Maryland ; Philosophy of Medicine^ Philadelphia^ 1845. On 
the recent Progress and future Prospects of Practical Medicine. 
See Beit, and Foe. Med. Kev., 1846, Vol. XXII. 

The materia ^^^- The Articlcs of the Materia Medica. — There is probably no 
medica. man more entirely sceptical in regard to their alleged properties and 
virtues than I am. There is no man who has been in the habit of 
using a smaller number of them. My own opinion is, that the number 
of substances endowed with active and peculiar or characteristic reme- 
dial properties is small. . . In many cases of disease all medicines, using 
the word in its common signification, are evils, and that they may be 
dispensed with, not merely with negative safety, but to the actual bene- 
fit of the subjects. . . The golden axiom of Chomel — that it is only the 
second law of therapeutics to do good., its first law being this, to do no 
harm — is gradually finding its way into the medical mind, preventing 
an incalculable amount of positive ill (Rev. p. 237). 

Assistnature ^^^' "'"^ ^^ comiug cvcry day to be more clearly seen that perhaps the 
orietthedis- most uuivcrsal and beneficial function of medical art consists in the 
removal and avoidance of those agents the action of which is to occasion 
or to aggra/vate disease^ thus giving the recuperative energies of the sys- 
tem their full sc pe and action^ and trusting to them when thus unem- 
barrassed and free for the cure of disease (ibid). 

Bm)D, Geoege, M. D., Professor of Medicine., King^s College, london. 
On Diseases of the Liver. London., 1845. 

Uver-dis- 690. In this country mercury has erenerally been resorted to, when 

the local symptoms have led to the suspicion that the Uver was dis- 
eased ; but I fear with no benefit to the patients. It has been well ob- 
served by Abercrombie : " On the liver-diseases of this country, mercury 



euse — and 
mercury. 



THE DOCTRINE OF PURGATION. 



161 



is often nsed in an indiscriminate manner, and with Yery undefined 
notions as to certain specific influence which it is supposed to exert 
over all the morbid conditions of this organ. If the liver be supposed 
to be in a state of torpor ^ mercury is given to excite it ; if in a state of 
acute inflammation^ mercury is given to moderate the inflammation and 
reduce its action " (p. 99), 



Ambiguous 
notions as to 
the actioD of 
mercury. 



CoPEMAN, Edward, Surg., A Collection of Cases of 



Explanatory Introduction. 
Vol. L 



London^ 1845. Bee 



lexy^ with an 

ANCET, 1845, 



691. The following collection of cases is published with the view of 
furnishing sufficient data for determining the comparative merits of dif- 
ferent modes of treating apoplexy, and for judging of the expediency 
of resorting to bleeding for the cure of that disease (Introduction). 
Here follow 250 cases. 

The conclusion is, that bleeding, generally speaking, is so ineflectual 
a means of preventing the fatal termination of apoplexy, that it scarcely 
deserves the name of a remedy for this disease ; that the treatment 
without loss of blood was attended with the most success, and that 
the mortality of the disease increased i7i proportion to the extent to which 
the Heeding was carried ; the more copious the loss of blood the more 
fatal the disease (pp. 198, 199 ; Lane, p. 533). 



Bleeding 
fatal. 



The more 
blood is ab- 
stracted, the 
fewer are 
the chances 
of recovery. 



Maokin, Charles T., M. D., On the Acute form of Gout, with RemarTcs 
on its similarity to Acute Rheumatism, In lancet, American Edi- 
tion, Vol, I, 1845. 

692. In a well-defined attack of gout, the pre-existing and gradually 
progressing derangement of all the organs which subserve the purposes 
of digestion and nutrition, coupled with the very remarkable increase 
of nervous irritability observable (as far as mj experience goes) inva- 
riably antecedent to a paroxysm, are sufficient, in a great measure, to 
warrant the conclusion that it is one of the most prominent examples of 
a local disease, depending solely for its origin on constitutional disturb- 
ance (p. 312). 



Gout; — & 
local disease 

from 
derangement 
of the digest- 
ive organs. 



693. It is, in the established rules of modern practice, to be taken Modern 
by storm, to be driven from the system " vi et armis," and all the means ^^*^^*^^' 
which an already overgrown materia medica places within our reach, 
have been and are brought to bear against it. Patients are cured ; 
" they get well." . . . From the first recipe traced on sand by the staff 
of Anaximander or Therecydes (the inventors of writing) up to the last Mian's ^S- 
'' fiat mistura," have w^e one which we can positively say will produce a ion of Ms art. 
certain and definite effect? No, not one. Medicine is then, as yet, 
nothing save a nice balance of contingencies (pp. 312, 313). 

A knowledge of Brandreth's Pills would have changed this opinion. 



694. The premonitory signs of its approach are generally to be found The precm- 
of a well-marked and definite character, so much so that in many in- ?SatS- 
stances he who has undergone a previous attack, can foretell with uner- '^se^%f evu 
11 



162 THE DOCTRINE OF PURGATION. 

^"^si^wct^ riiio; certainty the coming of a "^25," as it is termed, some time anterior 

aruf^ intes- to t^ie appearanco of tlie unwelcome visitor. The Jirst symptom which 

REMOVAL "V excites observation, is a considerable increase of nervous irritability^ 

^mlnTt^'^^^\l ^^^^ ^ ^Q\\eY'A2yeevishness and hastiness of manner. The sleep is restless 

Suute° The ^^^^ unrefreshing, disturbed with frightftd dreams^ tossing of the limbs, 

CURE. etc. The appetite (though not in variably) /a^^^ off. There is gastro-in- 

testinal derangement, with a sense of fidlness and oppression subsequent 

to meals ; dyspepsia and heartburn are pretty constantly present. As 

the symptoms become aggravated, the patient is annoyed ^\i\\ flatulence^ 

accompanied with sour eructations. . . . 

There is a bitter, or at all events, a vitiated taste in the mouth, espe- 
cially on lirst rising in the morning ; headache in those of plethoric 
habit ; the bowels are costive or relaxed — in either case the secretions 
are dark and offensive. The urine is of a saffron tinge, often scanty in 
quantity, and charged with lithic acid. These form the more remarka- 
ble prodromata, and, curiously enough, are observed to possess a distinctly 
intermittent character (p. 313). 

— These are, as the author expresses himself in another place, 
" not the ' hints^ but the ^positive directions^ laid down for the man- 
agement of the disease, for our guidance and. instruction, by Dame Na- 
ture'' (Lancet, A. E., Yol. I., p. 672). 



warning. 



The last 695. Of the near approach of the *^fit" the patient is warned by 

being seized at intervals with flying or transito7'y pains in different 
parts of the body, mostly affecting those portions of the frame already 
weakene(;l by previous illness (ibid.). 



The^arocB- gQg^ ^ most remarkable fact connected with the disappearance of 

ysm a salu- ^ •ii • 'ii 'pi* 

tary process the paroxysm IS that the patient, with the exception ot being more or 
cwre?"^""^"^ less crippled for a time, experiences a sort of general renovation of the 
system, and his state of health is better and more vigorous subsequently 
than prior to the fit. It seems as if the localization of this disease were 
a salutary process instituted by the " vis vitse " for the more effectual 
and complete removal 'of the cumulative disturbance of the general 
economy (ibid). 



The disease 697. I havo also obscrvcd that very slight causes will bring about the 
its ^Tppear- development of the elements of gouty inflammation, with which the sys- 
ances local. *tenn appears to be charged. I have known so trivial an accident as 
striking the great toe against a stone in walking produce a paroxysm. 
This peculiarity is often witnessed in those who are of confirmed gouty 
diathesis. Indeed, a man constitutionally subject to the disorder ap- 
pears " to wear his heart upon his sleeve," slight accidents, otherwise of 
no moment, being sufficient to induce an attack of this extraordinary 
disease (p. 314). 

Sara, Roberts, Professor of Medicine in the University of Milan. 
Sui Pregi e Doveri del Medico. Milan., 1845. 

Simple reme- 698. A physiciau of no great reputation would positively compromise 
his interests, if he limited himself to the prescription of simple remedies. 



THE DOCTRINE OF PURGATION. 



163 



The general ignorance obliges him to be a proselyte of the polyphar- 
macia / and indeed it is very easy to unite to any medicine a greater or 
less nmnber of substances which are quite incapable of modifying its 
properties. And it is also useful frequently to vary the medicines, 
because the public readily disbelieves in the knowledge of a physician 
who always prescribes the same remedies (p. 115). 

699. The principal means of obtaining success in practice is to limit 
one's self to a reasonable system of expectation^ and to prescribe in cases 
in which no active medicine is clearly indicated^ substances incapable of 
exciting remarkable changes in the animal economy (p. 120). 



Humbug es- 
sential to the 
"profession." 



Success in 
practice — 
how to 
obtain. 



Tayloe, J., M. D., Clinical RemarTcs on Cancer. See Report of the 
University College Hospital in Lancet, 1845, Vol. II. 

YOO. The commonest way in which cancer is propagated is hy the circu- 
lation of the cancer- cells in the hlood, and the arrest of them in the capil- 
la/ries, when they multiply and form tumors. In this case (the reported 
one) there was no ulceration. The organs that are secondarily affected 
by cancer have always some connection with the seat of the primary 
disease. We can easily see the connection between cancer in the breast 
and lungs. In passing through the pulmonary capillaries the cancer- 
cells are arrested, and thus the cancer is formed (p. 602). 



Cancer — 
cells in the 
blood. 

Purge and 
in removing 
prevent their 
accumulation 
in the arte- 
ries. 



YoGEL, Julius, M. D., The Pathological Anatomy of the Human Body. 
Leipzig, 1845. See Beit, and Fok. Med. Eev., 1846, Vol. XXIL 

YOl. Gases may be developed in the human body from two distinct 
sources — i'covcLfood in the intestinal canal in the act of decoirvposition 
and from decomposition of the tissues of the body itself. The gases 
produced in the intestinal canal occasionally permeate through its walls 
into the peritoneal cavity (Rev., p. 324). 



Foul gases 
from decom- 
position. 



Waddt, J. M., M. D., On Puerperal Fever. See Lancet, 1845, Vol. I 

702. When the intestines are hurdened with fecal accumulations the 
constitution becomes affected in various ways ; thus cerebral and vis- 
ceral congestions, phlebitis, &c., may be the result of pressure on the 
larger vessels. The intestines are distended beyond their tone, and give 
rise to flatulency, anorexia, indigestion, and there is ^Yobdihly absorption 
of putrid matters, which may all tend to promote a highly unfavorable 
state of the general system (p. 674). 



Effects of re- 
tained fzeces. 



703. The phenomena of the typhoid and ataxic {nervous) fevers, 
whether common or puerperal, will be best explained as the consequences 
of poison — either generated within or introduced from without — the 
fever being strictly an effort of nature to throw off^ injurious matter 
from the living body (pp. 698, 699). 



Fever— \\\e 
effort of na- 
ture to elimi- 
nate poison. 



164 THE DOCTRINE OF PURGATION. 

BemittenK^. T04:. jRemiUent and intermittent fencers — the consequence of nature's 
endeavors to elhninate a poison from the system by the biliary organs 
(ibid.) 

IMPOETAN^T QUESTIGJSrS. 

Tuipidity of '<'05. Does the rapidity of pulse (in fever) depend upon a law of na- 

thepuise. \^^yq to make up, by rapidity of distribution and change^ for a deficiency 
of vital principle in the blood, or is the heart directly stimulated into 
increased action hy morbid onatter in the blood f (Ibid.) 

Clendin-ning, De., Report to the Royal Medical and Chirurgical Soci- 
ety^ January 13, 1846. See Lancet, 1846, Yvl. I. 



Hydroceph- 
alus from 



706. T. 8..Allen^ Surgeon to St. Marylebone Infirmary, has seen in 

srppRE^En more than 500 cases of diarrhoea in children^ whose ages varied from 3 

DIARRHOEA. j^Qj^^]^g ^q ^ ycars, that in at least 6 to 1 the diarrhoea was symptomatic 

— a salutary effort of nature to relieve the system — to suppress which, 

by opiates and absorbents^ was to invite head-symptoms, hydrocephalus, 

convulsions^ and death (p. 101). 

Hall, Marshall, M. D., Practical Observations *and Suggestions. 
London, 1846. (+) 

refuge of ig- YOY. That invariable refuge of the timid and ignorant — the lancet ! 

norance. 

Milk-fever- 708. I am of Opinion that what is designated '' milhfever^^ is fre- 

pietion^vftii qu^eiitly symptomatic of the condition of the mammae. The remedy for 

^ature's this febrile state is therefore depletion of the milk-ducts. As a preven- 

^pv^gation. tiou of milk-absccss and milk-fever, and with other hygienic objects, the 

infant should be put to the breast at the moment it is born. If, in spite 

of this, the breasts become in the slightest degree tumid, or febrile action 

is set up, another and a stronger infant should be applied without delay. 

This is nature's mode of relief, and infinitely more efficacious than the 

application of leeches. . . The patient must take barley-water as her 

sole nourishment, and the bowels must be freely purged. 

Hareison, J. B., Surg., Essays on General Pathology. London, 1846- 

47. (+) 

The Uood ^^^' -'-^ ^^ ^^^^ place, it is manifest that the presence oi foreign 

may become ruatter in the blood must induce a state of derangement. In the next 

Sr^mlf- place, it is equally clear that if the blood do not undergo those changes, 

ent modes. ^]^{(3i^ j^ jg dcstiucd to rcccive during its transmission through the lungs, 

it can no longer preserve its healthy constitution. In the third place, 

the blood itself may be imperfectly elaborated (ISTo. Y.) 

Medical men ^^^' "^^ ^^ ^^^^ kuowu that the faculty do not themselves take medi- 
have small Qines in thc samc manner that they prescribe them to be taken. They 
o^yJii ^"rli^^ have not, it must be owned, that large credence which they require from 
^^^' others. There is not with them the regular taking of spoonfuls at stated 

intervals, and the expectancy and confidence of the forthcoming result, 

which they ask of others. 



THE DOCTRINE OF PURGATION. 165 

Leeson, John, M. R. C. S. E. Liehig^s Philosophy applied in the 
Treatment of FuncUonal Derangement and Organic Disease. 
^ London, 1846. 

' 711. There are d^houi four hundred and ten preparations in the Ta^pUwr. 
pharmacopoeia of tlie Eoyal College of Physicians. Now, any practical *""^''^'^*^' 
man of ten or twenty years' standing must have found that four hund- 
red of these preparations are of little or no "lvalue whatever in the treat- 
ment of any form of disease, and that about the remainin^g ten might have 
assisted him in reducing, at one time or other, cases occurring in every 
department of his practice. I^early all the waters, confections, decoc- 
tions, extracts, infusions, liquids, mixtures, essential oils, spirits, tinctures, 
have little or no influence over any form of disease, when used as inter- 
nal or external remedies. Many of the mineral preparations are abso- 
lutely injurious in their effects under every circumstance, while the 
retention of other remedies is burlesque and nonsense (pp. 10, 11). 

712. Fancy aluminum, antimony^ silver^ arsenic, harium^ hismuth^ Metallic 
calciuTn, copper^ iron^ mercury, magnesia, lead^ potassium^ sodium, zi/nc remedies, 
(all of which are to be found in the London pharmacopoeia of one hund- 
red years' standing, with the exception of barium and bismuth), as 
medical agents which are yet authoritatively retained, and which have 

been at one time or other plied as sovereign remedies for many invet- 
erate forms of disease, although most of them, if not all, are abandoned 
by every practitioner of standing and experience as the most dangerous 
applications for any kind of medical pu|!poses (pp. 12, 13). 

Magendie, M., M. D. Introdiictory Lecture in the College de France, 
1846. Bee Lancet, 1846, Vol. L 

713. When disease requires assistance, we may still by well-judged Assist nature 
intervention assist nature in overcoming the functional derangements ^^ ^^' 
which gave rise to the disease (p. 238). 

714. Tartar emetic, when brought into contact with the blood, has Tartar- 
the power of dissolving the globules (p. 363, citation in the paper of *"*^^*''' 
Butler Lane, Surgeon). 

Wilson, J. A., M. D., On the True Gha/racter of Acute Rheumatism * 
in Lancet. 1846. (-{-) 



715. Inflammation is but an expression of the nutritive function innammo' 
endered difficult for the time in particular structures. Inflamma- ^ii^ZT\ni 
tion originates no movement, creates no function, brings no new nature's 
elements into operation ; it is not an acquired principle, but an innate ^"'"°^* 
faculty held in trust by every living structure from the beginning, for 
the means of self-protection, and as a security under injury for redress. 
Thus considered the arthritis of acute rheuinatism is respected by the 
physicians as salutary under circumstances, and as working with the ^^tST 
fever to a cure. 



166 



THE DOCTRINE OE PURGATION. 



Acute rheu- 
matism. 



Opium and 
lancet ; — 

poison and 
bloodshed 
denounced. 



Localization 

of fevers 
according to 
the poisonous 
matter in the 
general cir- 
culation. 



Disease from 
change in 
the propor- 
tion of ~ the 
natural ele- 
ments of the 
hlood, 



The blood 
feels and 



716. Opium i7h acute rheumatism.. — The healthy relations of this 
drug with the blood (and it is prescribed on no other indication) are not 
such as to authorize its employment in a disease whose principle of cure 
is one of unrestrained spontaneous action. 

TIT. These a]) proved princijples of cure hj poison and bloodshed rest 
professedl}^ on more than conjectural science for their authority ; they 
are not set forth diffidently, as the experimental misgivings, by small 
induction, of a theory yet to be realized, but are proclaimed as the 
dicta of a bold and successful experience ; they are blazoned as heroic 
mottoes above the vulgar host, that seeing them we may know our 
leaders and be prepared to follow them. 

T18. As the scarlet-fever localizes itself especially in the throat, the 
measles in the mucous lining membrane of the lungs, the epidemic 
typhus in the coecum and lower ilium, and the erysipelas fever in the 
integuments of the head and face, so is the rheumatic fever determined 
by special eifects of inflammation to the larger joints of the hody and 
the surrounding articular 'structures ; but the heat, swelling, and redness 
thus induced are no more the cause of the constitutional disturbance in 
acute rheumatism than the scarlet-rash, or the small-pox pustule of the 
fevers that bear their respective names. They are but the partial 
expression, by impaired nutrition, of a disorder that is general to the 
system. 

T19. Assuming the evil was in the blood, not so much from impuri- 
ties as a change in the relative proportions of its necessary elements, we 
might rationally expect the com'position of some structures or products 
to be more influenced than others by an excess or deficiency of prin- 
ciples important to their very existence, since the greater frequency 
with which particular parts are affected only indicates that the tissues of 
which they are composed, and the fluids which permeate to them, are such 
as to be especially affected by a morbific cause which prevails to a 
greater or less degree throughout the system. 

T20. There is in the hlood an independent faculty of sensation 
which by physiologists is not as yet acknowledged. In disease, as in 
health, it is sentient of its own states, as it is inceptive of its own actions, 
and through it we feel much of what, in idle phrase, is made exclusive 
to the nerve. 



Acute rTifv^ 
raat sm can 
cure itself. 

Bleeding, 
opiwm, and 
culoTTLel, if 
they do not 
kill, compli- 
cate the dis- 
order. 



T21. The fever of acute rheumatism is competent to the task of its 
own cure. Yet the patient is made to pay hy the lancet for its acuteness, 
and swallows every specific for gout and neuralgia in right of his rheu- 
matism. . . From this practice, there is reason to believe that many of 
the dangerous complications so frequent of late years in the pathology 
of acute rheumatism do in truth proceed. In the well known combin- 
ation of opium and calomel, this mischievous diligence of treatment 
receives its most frequent illustration. The objects proposed in this 
heroic formula are the immediate and complete extinction of fever, pain, 
and inflammation. 

It is a rude and empirical practice which seldom succeeds, and fail- 
ing of success is most injurious to the patient ; it has destroyed very 



THE DOCTRINE OF PURGATION. 167 

many who, under less popular and energetic methods of treatment, cuffX'uri- 
would have recovered. . . patient! *^^ 

There is more wisdom, for there is less cruelty, in hommopatky^ hydro- 
pathy^ or animal magnetism. Yet the courage is with those who refuse 
to prescribe. 

Let young medical men ponder. 

Purgation 



Y22. Purgation. — Its simplicity ill accords with the impatient vio- -itSpUc 
lence and affected combinations of modern therapeutics ; yet of consti- '^^y- 
tutional methods of cure, no one, by long practical experience, has been 
more thoroughly approved. 

Y23. To secure effects by ]3erspiration, opiurn^ antimony.^ ipecacuanha^ ^^mt 
ammonia^ liave been imsparingly added to the system^ already taslced by 
an active disturbing principle, to its utmost means of resistance. 
Hence, from undue haste, violence, and inconsistency of action, a great 
loss of the credit which would otherwise have attached to the sweating 
practice in rheumatic fever. 

Imperfect sweating catcses offensive matters to remain in the ducts 
and pores. 

Sweating to be beneficial must come on spontaneously, with no aid from drugs,. 

Dick, Robeet, M. D., The Treatment of Dyspepsia. See Lancet, 
184Y. Vol. L 

724:. Ocecum. — In all cases of constipation or torpor of the bowels, consu-^ 
attention to the caecum is important. It is here that fecal accumulations ^^nlTik~thl 
are, on several accounts, apt to take place. The circimistance of the large ^Jjf^^^j^ 5^; 
howel here forming a cul-de-sac^ out of which, moreover, the fecal mat- flammatioa 
ter, during 14 or 16 out of the 24 hours, can only escape by a course dZTd/c^ce's. 
counter to gravity, disposes not a little to the collection there of excre- 
ment. And indeed, in most cases of constipation, in cases of chlorosis, 
&G., we shall generally both see and feel a fullness of this part, some- 
times of remarkable and even alarming extent and hardness. . . . And 
I have no doubt that in not a few cases a state of chronic irritation of 
(sub-) inflammation and even of ulceration of tlie mucous membrane of 
the caecum, is induced from the long contact with hardened fseces w^hich, 
moreover, have become preternaturally fetid and undergone certain irri- 
tating chemical decompositions. In such circumstances either round or 
irregular masses of a fatty looking substance may often be detected in 
the evacuations. This consists of inspissated mucus, secreted by a sur- 
face highly irritated or {sub-) inflamed. A slight prolongation or 
increase of such irritation will convert this inspissated discharge into a 
purulent one (Lane, p. 32). 

725. In impure states of the fluids we prescribe purgatives on the The 
following assumption, namely, that if we, ly artificial means, afford ^^^^f^^'^ 
nature the opportunity, she will, by emunctories whose action we excite, 
discharge herself of morbid principles, Yetammg those that are healthy. 
This, indeed, is the grand general law, in faith of which we venture^ %n 
any case, artifi/iially to meddle with nature (ibid. p. 88). 



168 



THE DOCTRINE OF PURGATION. 



Sherwood, John Burdett, M. D., On Dyspepsia. London^ 1847. 

rH%ofdis- 720. I aiii of opinion that tlie proximate canse of all diseases con- 
^^^' sists in scnne alteratimi hi the force, quantity, or quality of the circulat- 
ing fluid j and that, of those affecting the general system, vitiation of 
the hlood is an invariable accompanhnent (Preface). 



Johnson, Edward, M. D., On Ihfe, Health, ojnd Disease, 
Edition. New Torh, 1850. 



America/n 



Purgation ^^'^' Duvqation, like exercise, accelerates what Liebiq calls the choMge 
accelerates gf flatter — that is, the daily disorp-anization and reor2:anization of the 

i^e change J /. t t i' t t •, i ^ i -77 7-7 • i 

of matter, elements 01 the blood and vital organs, by more rapidl/y expelling the 
old and worn ont material and supplying its place with new (p. 96). 

Old age tue '728. There is bnt one legitimate canse of death, and that is old age. 
m^te ^?iuse If ^'^V ^<^^ ^'^^ whiU any of his organs is unimpaired, he dies pre- 
of death. maturely, and before he has fulfilled the final canse of his existence 
(p. 98). 



senith and 729. The health of the body depends upon the healthy performance 
Aiithe?egiti- of the nutritive actions, and disease consists in the unhealthy perform- 
S^*medfdne ^^^c of thcsc actious, or of ouc or more of them. Medicines, therefore, 
^^ur^ative/ ^^^ ^^ ^'^<^^ value noT power over disease, excepting as they have the 
power of increasing or diminishing the activity of the nutritive actions, 
tion, secretion, circulation, (&c. (p. 88). 



If from indi- 
gestion or 
overfeeding 
our food does 
not become 
blood, the 
system is 
filled with 
gases^ etc. 



730. We cannot derive any benefit from what we eat except from that 
portion of it which in due course becomes blood. All that we eat, there- 
fore, heyond what can he converted into Hood, is either changed into fat, 
or is left in the stomach and bowels to run into fermentation, serving no 
other purpose than to distend these organs with all sorts of pernicious 
a/nd offensive gases (pp. 81, 82), 



Irajjerfect 
digestion — 
{constipa- 
tion) — how- 
it impover- 
ishes and 
poisons the 
ilood. 



Good illus- 
tTation. 



731. The result of improper digestion is that the necessary change 
which should be wrought upon the food in order that it may nourish our 
bodies, is very imperfectly effected — the chyme is of unsound quality. 
The next result is this : the chyme, by admixture with certain other 
juices which it meets with in the bowels, is destined to become chyle. 
But the chyme being of vicious quality, the chyle which is formed from 
it must also he vicious. At all events it must be deficient in quantity ; 
certainly it is impossible to suppose that as much perfect chyle can he 
elaborated out of had chyme as of good. You might as well hope to 
make as much good huiter out of had cream, or out of crea^n and water, 
as o%it of pure cream. The chyle, therefore, is deficient in quantity ; 
but this chyle is destined to become blood. The chyle, therefore, being 
deficient, the blood resulting from it must also be deficient (p. 125). 



Thehiood 732. Dut the hlood is in fact the real food on which the hody feeds, 

menton-L and this food being scantily supplied, the strength of course is ill-sup- 

body. ported. But there is another mischievous result of this condition of the 

stomach and bowels, beyond that of unhealthy and deficient gastric 



THE DOCTRINE OF PURGATION, 



169 



juice. In that condition of the health which I am endeavoring to 
describe, the stomach and bowels actually secrete air. It is a thoroughly 
established fact that air-wind— flatus — is actually formed from the blood, S'°lnT7t8 
and poured into the stomach and bowels by those arteries which ought effects, 
to form only gastric juice. Now, this wind not only does no good in 
the stomach and bowels, but it does a vast deal of harm. For, besides 
the evil effects which it produces by its pernicious qualities, it molentVy 
distends these organs^ stretching and separating, and thus greatly weak- 
ening and destroying the firmness and compactness of their ultimate 
tissue (pp. 125, 126). 



Wegg, William, M. jD., Observations Relating to the Science am,d Art 
of Medicine. 



London^ 1851. 



733. A highly important action of medicines upon the intestinal sur- 
face remains to be noticed, as affecting its excretory function. I do not 
mean the process which eliminates from the villous surface a fluid largely 
composed of water, containing the remains of the epithelium, &c., and 
which almost any irritating cause may excite, but the excretory function 
of the glands which thicTdy stud the surfaces of the howels^ and, fsjpe- 
cially those of the large intestines. Although the lungs, liver, kidneys, 
and skin contribute largely to the depuration of the body, there is little 
doubt that these glands contribute greatly to the same result, very proba- 
bly by expelling matter different from that which those other depurating 
organs eliminate (p. 213). 



Purgati/ve 
medicives — 
their action 
on the colon. 



Haspel, a., M. D., Medical Staff of the Algerian Army. Maladies de 



VAlgerie. 
Yol.X. 



Paris. 1852. See Med. Chir. Kev., ]S"ew Ser.. 1852, 



T34. In this season of the year {autumn in Algiers) every individual 
seems to be endowed with an especial susceptibility to the development 
of typhoid symptoms, when he becomes the subject of dysentery, inter- 
mittent or remittent fever. But these accessory phenomena, the stupefied 
countenance, the restlessness, heat of the belly, &c., quicJdy disajppean^, 
at the same time with the principal disease, under the influence of an 
evacuating plan of treatment. We must distrust the fulness of pulse, 
the false plethora, which manifest themselves during the prevalence of 
the great heats, and which seem to call for hleeding. If we yield to this 
perfidious indication, we find our patients fall into a state of adynamia, 
without the dysentery undergoing any amendment ; or, if the abstraction 
of blood produce any relief it is but temporary, to be speedily followed 
by a sensible aggravation of all the symptoms (p. 58). 



Malignant 
fevers 
ablkid. 



Purgation, 
the cure. 



Bleeding 
kills. 



735. Mr. Haspel refers to the advantages derivable from purgatives, 
recorded by the old writers, and considers that their disuse in recent 
times has arisen rather from the prevalence of theoretical views of the 
inflammatory nature of diseases than as a result of experience. 

He speaks highly of emetics at the very outset of these diseases (pp. 
9, 11, 39 ; Kev., pp. 106 sq.) 



Theory and 
practice. 



i'l 



170 THE DOCTRINE OF PURGATION, 

Carpexter, C. Willloi B., M. D., Prinevples of Human Physiology. 

London^ 1853. 

Pure Mood 736. I firmlv believe that if the hlood of a person of sound constitu- 
cSagwns. ^^<^^^' ^^ l^ept in a state of perfect purity hy the moderate use of whole- 
some food and drink^ by the respiration of pure air, by adequate exer- 
cise not pushed to over-fatigue, and by personal cleanliness, he is as 
completely protected against the invasion of cholera as he who has been 
effectually and recently vaccinated is proof against small-pox. . . The 
same is true of all contagions and diseases, and hence the universal value 
of purgatives, which quickly restore the above conditions, if any aber- 
ration has taken place (chap. lY.) 

Dickson, Samuel H., M. D., Professor Med, College of South Carolina. 
Elements of Medicine. Philadelphia, 1855. 

^oJ^lTh^ 737. The hlood is often indirectly poisoned by the influence of con- 
comes im- tingencies which prevent the elimination of such effete mattei's as must 
freely diS- be got rid of to keep it in a normal condition. We have reason to infer 
eased). ^j^^ existcuce within it of injurious ingredients, whose presence we can- 
not demonstrate by the ultimate results. The blood may thus become, 
so to speak, passively diseased (p. 111). 

^IS!^purga- '^^^^ ^^ ^^ ^^^® ^^ influcma, purgatives aid in reducing to its proper 

tives. level the vascular excitement; while we " derive " from the head and 

throat hy determining to the gastric intestinal surface (p. 313). 

The Hood— 739. The blood is found altered in disease : 

i? ^becomes ^' ^J ^ chaugc lu the proportion of its constituent elements ; 

impure. 2. By the addition of foreign matters (p. 111). 

Demands careful attention. 

wiifitfor- 740^ ^ 2*reat variety of foreign matters may be absorbed into, mixed 
chymists With, auQ detected m the blood. Kramer lound m it silver, alter the 
^fj^^Siellood. nitrate and chlorate had been taken. GEsterlein discerned globules of 
inercury in it, as Avell as in the saliva and urine of persons who had been 
taking mercurials. Heller found iodine and hromine in the blood of 
patients to whom these remedies had been administered. Nitrate, hy- 
driodate, and carhonate of potass, antimony, and carhonate and sulphate 
of iron have been found in similar circumstances. Quinine may be dis- 
covered in the urine, which it must reach through the vessels i and lead 
is shown in the gums and in the hrain of those poisoned by that metal 
(p. 111). 

COKSEQUElSrCES. 

other_ mpu- 741, T\iQ foreign matters which, as causes of diseases, enter the hlood, 
are not always, however, to be thus exhibited by chemical tests and re- 
agents; hut their presence ca7i he inferred as indisputahly ihovi^\ less 
j)alpably. . . Blood thus poisoned hecomes in its turn poisonous. The 
glands are irritated by it, and the secretions and excretions become mor- 
bid (p. 112). 



nties. 



THE DOCTRINE OF PURGATION. 171 

742. The sugar excites the hidney into diabetes, the carbon and urea forms"o7di3 
oppress the brain with coma. Its chemico-vital relation to the tissues ease induced 
undergoes essential changes, and infiltration and exudation, congestion, ?L.*"'^^^'^*' 
dropsy, and hemorrhage follow. It ceases to be nutritious, and atrophy 

and marasmus follow, or its nutrition is perverted and morbid, and we 

have hypertrophy, or deposition of scrofulous, tubercular, typhus or ' 

cancerous matter (ibid.) 

Bennett, John Henry, M. D., Editor of Edinbuegh Medical and 
Surgical Journal. 

743. The mortality from pneumonia has diminished since large ^^^^^^^^ ^^ 
bleedings have been abandoned. (Present state of theory and practice pnmmonia. 
of medicine. Journ., Yol. I., 1856, p. 19.) 

Y44:. Pericarditis.— ^ovae few years gone by, the practice was to Pericar- 
meet the violence of the inflammation by the extremest antiphlogistic 
measures ; the lancet was plied with a most unsparing hand, and with 
the most unhesitating faith in the propriety of its use. But where are gjo^^jettin 
the believers in, or imitators of, such a practice now ? This " heroic and and mercury 
certain method," as it was called, of arresting the destructive agent — of *^°^*^®°^®^- 
exterminating the disease — has been convicted of error, and condemned 
by a late authority as " uncertain and very dangerous. '''' Again : " after 
hlood-letting, rapid induction of the mercurial influence is of the greatest 
consequence," wrote an authority in a most unhesitating style some fif- 
teen years ago. But now we find one of the most observing and practical 
physicians* among us admitting, that the firm faith which he himself 
once reposed in the efficacy of the remedy had been undermined by the 
truth-telling effects of further experience. In short, " the errors and 
absurdities," says Dr. Markham, " into which men have been led through 
this hastening to be wise — the fallacious and extraordinary proceedings 
in practice it has involved them in — he who is desirous of learning will 
find recorded on every page of the history of medicine. By thus casting 
dust in the eyes of others, and perverting our own wisdom, we raise up 
positive barriers to the advance of true knowledge ; for now the mist of 
delusion which our faulty haste has generated must be swept a\'7ay 
before the honest face of the simple fact can be made available to light 
our slow steps along the difficult passes of new knowledge (Journ., vol. 
I., 1866, pp. 1038, 1039). 

T45. The very discordant opinions which equally honest and equally Medical 
skilled observers maintain — observers not living in separate ages, or in ^p^ejudSar 
different countries, or in separate cities, but exercising their art upon stubbom- 
the same disease, under the same roof, in the same public hospitals — 
must have a meaning. Is it not one which is oftener than we care for 
to confess, responded to by our consciences at the bedside of the patient ? 
(ibid., p. 1039). 



* W. 0. Markham, M. D., in his " Diseases of the Heart, their Pathology, Diagnosis, 
and Treatment." London, 1856. 



172 THE DOCTRINE OF PURGATION. 

iu,f!a»wui- YttO. IS^oiie but men ignorant of patlioloi>;y now talk of " knocking 

ther'weed- down '' inflammation with hlood letting^ or loith unercury. Indeed, why 
cufy cure?" ^l^^sc remedies are employed at all, lias^ to use the word of Dr. MarJc- 
Juwi, '' yet to he shown " (ibid., p. 1042). 

Bennett, J. Hughes, M. D., Professor of Medicine in the University 
of Edinhurgh. Observations on the Results of an Advanced Diag- 
nosis and Pathology^ etc. Edinbiirgh^ 1856. See Edinb. Med. and 
SuEG. JouKN., Yol. Z, 1856. 

Pastexpe- 747. Medicine is not a scientific art^ which is dependent for its 
theories— oi principles on the study of and commentary on the older writers. . . On 
"me'Scar the Contrary, it is the hooh of njjutwm-^ which is open to all, that we ought 
the^fSt — *^ peruse and study; and why should we read it through the eyes of the 

begin "de sagcs of former times, when the light of science was comparatively 



novo. 



the hlood. 
Bloodletting 



feeble and imperfect ? . . . The lesson which a careful study of 
history of medicine has forced upon me, is the necessity of reinvestigating, 
with all our improved modern appliances, the correctness or incorrect- 
ness of existing dogmas, in order to establish an improved practice for 
the future (Propos. I. ; Journ., p. 773). 

Small-pox. 748. Dr. Wm. Addison (Cell-therapeutics, 1856) correctly points out 

The pustules ^^^^ ill tlic distinctlvc eruptive fevers, such as small-pox, the numerous 
—the matter small abscessBs in the shin eliminate the morbid poison, which formerly 
creted from cxlstcd lu tlic blood, and are in this way essential to the cure. This 

provident action he denominates " Cell-therapeutics.'^'^ In all such cases 

experience has shown that time and a natural sequence of changes is 
is injurious! necessary for a restoration to health, and that the idea of cutting short 

such changes by bleeding is alihe erroneous in theory and injwious in 

practice (rropos. III. ; Journ., p. 777). 

^^oodietting 749^ LaTffc and carlv bleedin^cs have been practiced under the idea 

— the theory ,. .«^. «/ */. i • !• n - 1 

far more ap- that by diminishing the amount oi the circulating rluia — 
pw^gluon^ 1. The materies morbi in the blood would be diminished ^ 
2. Less blood would flow into the inflamed parts ; 
• 3. That the increased quantity of blood in the parts would be les- 
sened ; and 

4. That the character of the pulse was the index as to the amount 
of fluid that ought to be drawn (ibid. ; Journ., p. 776). 

^mo^ves'^he^ 750. The carcful investigations of chemists, and especially those of 

good ^ and Andral and Gavarret, Simon, Becqueril and Rodier, and others, have 

baHo re- further shown us, that whilst venesections greatly deteriorate the blood, 

™*^^ rendering it poorer in corpuscles and richer in water, they haA)e no effect 

in eliminating morbid products, and that in the vast majority of cases 

ELIMINATION IS IMPEDED BY BLOOD-LETTING (ibid. ; Joum., p. 778). 

inflamma- 751. Inflammation having occurred, the great work now to be accom- 
nat/tjuraid.^^ plislicd is to break up the exudation that has poured out, to remove the 
uve cure"?S pressure it exerts on the nerves and blood-vessels, and render the whole 
capable of being eliminated from the economy, either directly, by dis- 
charge externally, or indirectly, first, by passage into the blood, and 
secondly y by excretion through the em^mctories (ibid. ; Journ., p. 779). 



8(Mme. 



THE DOCTRINE OF PURGATION. 



173 



Y52. jN'ow, it requires to be shown that draining the body of blood 
cannot in the slightest degree influence the congestion in the inflamed 
part. There the vessels are enlarged, the current of blood is arrested, 
the blood-corpuscles are closely aggregated together and distend the 
vascular tube, and are in no way affected hy the arterial current^ even 
when increased in its neighborhood. That opening a vein can alter this 
state of matters is scarcely to be conceived ; and if it could, how would 
this assist in removing the exudation which has coagulated outside the 
vessels ? (ibid. ; Journ., p. Y80.) 

753. So far from getting rid of inflammation by weakening the pulse, 
we not only fail to do so, but prolong the time for the transformation of 
the exudation. This, indeed, is acknowledged by Louis^ Chomel and 
Grisolle^ who distinctly show that the progress of a pneumonia is nemer 
shortened ly Heeding (ibid. ; Journ., p. 781). 

754. It is injurious to diminish hy hleeding the nutriti/ve processes 
themselves, when they are busily engaged in operating on the exudation, 
and eliminating the morbid products (ibid. ; Journ., p. 781). 

755. The phenomena of fever and excitability following inflamma- 
tion^ have been wrongly interpreted. In themselves they are sanative^ 
and indicate the struggle which the economy is engaged in, when at- 
tempting to get rid of the diseased processes ; and we only diminish the 
chances of that struggle terminating favorably, by lessening the vital 
'powers at such a critical juncture (ibid. ; Journ., p. 782). 



Inflamma- 
tory action 
described — 
bloodletting 
useless — in- 
dication for 
purgatives. 



Bleeding 
jjrolongs 
disease. 



Bleeding 
retards 
recovery. 



The crisis 
must not be 
interrupted 
by hleeding. 



756. Assuming it as granted that in some cases the pain is/br a time 
relieving by bleeding, and that in pneicmonia the respiration tempora- 
rily becomes more free — at what cost are these advantages obtained, 
should the patient be so weakened as to be unable to rally ? Even if he 
does rally, a large Heeding almost always prolongs the disease (ibid.). 



Bleeding a 
dangerous 
palliative 
which pro- 
the 



757. Clinical Lectures on the Principles and Practice of Medicine, non^o/m 

— lungs. 



New York Ed,, 1860, 

In all hepatization.^ the object of nature is to reconvert the solid exu- 
dation once again into fluid, whereby it can be partly evacuated from 
the bj'onchi, but principally absorbed into the blood., and excreted front 
the economy. Gradually the solid amorphous mass is converted into a 
fluid crowded with cells. This is pus. The cells, after passing through 
their natural life, die and break down, whereby the exudation is again 
reduced to a condition susceptible of absorption through the vascular 
walls, and once again mingles with the blood, but in an altered chemical 
condition. After undergoing various changes in the blood., the exudation 
is finally removed from the economy (pp. 265, 266). 



The natural 
and the pur- 
gative cure 
the same. 



PiCKFOED, J. H., M. D. Hygiene, London, 1858. 

758. Malaria is modifled by altitude. If the elevation be consider- DUute the 
able, the temperature will necessarily restrict the fever to the intermit- >°^P""tyand 



174 THE DOCTRINE OF PURGATION. 



yoti 

the disease 



hea<!e ^^^^^ fomi ; wliilst loi the plain beneath, the same noxious emanations 
wouki produce, in tropical climates, remittent or yellow fever, plague 
or pestilential cholera (§ 966, p. 172. Cf. Brown). 

r a'^^jT^ior ^^^^' ^ healthy adult respires twenty times in a minute, and takes 
purgation luto liis luugs, at each respiration, twenty cubic inches of air, or 576,000 
eptdemks, cubic iuchcs in twenty-four hours. This respired air comes into contact, 
maiaS' '^* ^'^^^^ inspiration, with 201,600 square inches of mucous surface of 
influences, air-passagcs and cells. Is it, therefore, matter of surprise that atmos- 
pheric air, contaminated by infectious or contagious matter, or poisoned 
by malarious, miasmatic or paludal emanations, should exert its baneful 
influence on the hlood and on the organic fiervous system, through the 
nerves distributed to the enormous superficies with which it comes in 
contact at each inspiration ? The wonder is, that any of us escape ! 
(§932, p. 165.) 

Insensible 760, The sum of the cutaneous and pulmonary secretions amounts, 

^/^— ut according to the best authorities, to two pounds, eleven ounces, three 

anS° wuh ^ii'^chms, and twelve grains in twenty-four hours. The cutaneous 

mine. exhalation is a true secretion from the hlood, somewhat analogous to that 

of the urine, of those matters which, at the temperature of the body, 

are capable of assuming the gaseous form, as carbonic acid and water 

(§§ 1101, 1102, p. 206). 

Hazard, Thomas H., of Yaucluse, R. I. Purgatives, 

761. Doctors' and undertakers' fees are so high that it is very incon- 
venient for persons of small means to be sick or die in these times. 
That most of the maladies that prevail in our climate may be prevented 
by proper care I have no doubt ; and that most of the sicknesses that 
do occur may be cured at a trifling expense and loss of time, I am, after 
half a century's observation and experience, equally certain. I think 
men and women would now survive to the average age of seventy, 
instead of half that term of years, if they would live and practice in 
harmony with the laws of their being ; which, like all N^ature's works, 
are ever found to be as simple as they are grand, when understood. 

762. Moses was inspired to utter a great truth when he declared 
that " The life of the flesh is in the hloodP Action is life ; and the 
blood is the organ by which it is communicated to every member of the 
body. It follows that if the organ be out of tune, the music or har- 
mony of life cannot be complete, however cunningly it may be piped 
upon. If there is discordancy in the instrument, it is not the fault of 
the law — 'Which is ever perfect in itself — but it is the fault of man's 
animal propensities that transgress the law. 

763. The blood that imparts life and nourishment to the system 
feeds upon the food we eat, the fluids we drink, and the air we breathe. 
To preserve its purity we should eat to live, rather than live to eat. 
Eat slowly, chew the food well, drink sparingly, -even of water, and be 
temperate in all things, and one half of the primary causes of disease 



THE DOCTRINE OF PURGATION. 175 

will be removed. Hilarity and cheerful conversation whilst at the table 
greatly assists digestion. A hearty, prolonged, explosive laugh will 
well nigh split a pine-knot on its passage to the stomach. 

See to it, as far as is practicable, that you breathe un contaminated 
air ; for every breath we draw comes in contact with the blood, and 
imparts to it its own quality, whether it be the savour of life to life or 
of death to death. Look especially to your sleeping-rooms that they 
are daily (and if small nightly) ventilated. Avoid beds, and particu- 
larly pillows, that are filled with blood-shotten feathers. Keep the 
pores of the body open and clean by frequent bathing, for each of these 
are pipes that gives tone to life's organ. Above all things look to it 
that there is no decaying vegetable matter of any kind near or under 
your sleeping apartments, for probably more sickness occurs from this 
cause than any one other. If at any time you begin to feel dull and 
heavy and good for nothing — if you lose animation, and your flesh feels 
numb and sore; if your mouth grows clammy^ and your tongue y^r6'y 
if your eyes feel as if they had sticks in them, or your head, or side, 
or back begins to ache, or old sores and weak points of the system 
grumble y it you snuffle, or your voice grows husky, accompanied with 
a hacking as if to clear the throat — lose no time in ascertaining and 
removing the local cause, if possible, before you are stricken down by 
disease. Proceed first to your cellar, especially if you sleep on the 
ground-floor. Examine it well in every nook and corner. You may, 
in your researches through its dark labyrinths, perchance stumble upon 
a dead cat, and perhaps some festering rats ; but heed them not. Their 
aroma is not pleasant, but it is not deadly poisonous ; but, if you should 
fall in with a rotten turnip or potato, or cabbage, or any other decom- 
posing vegetable, eject it at once a stone's-throw from your house, with 
every vestige of its remains, even to the earth it has impregnated ; for 
the miasma that arises from a peck of decomposing vegetables of any 
kind, if inhaled into the lungs, and consequently blood, especially 
during sleep, is* sufiticient, with the aid of the lancet or of a little 
morphine, to kill a regiment of hardy men, and the stronger and more 
robust they are the more certain will be their doom. I have myself 
known, many years since when the lancet was in vogue, scores of hardy 
young men and women perish under such circumstances in a single 
country town of this State, whose lives might have been easily saved, 
I am entirely confident, under a different mode of treatment. I have 
now in my recollection a certain Doctor Sangrado, who then practiced 
in that town, of whom it might with truth be said " Death followed 
after him." He seldom entered a family at the season of year when 
these morbid attacks were most rife, without sending one, two, or three, 
and even ^^^ in one instance, to their graves. Weakly patients, whose 
strength of constitution was not competent to carry any considerable 
portion of morbid matter in their blood before it gave way, stood some 
chance of life under the bleeding treatment of that day, but those of 
strong constitutions stood but little. These, when attacked, generally 
kept about until their blood became so thick and sluggish that it 
coursed with difficulty through the thousands of little ducts and vessels 
that carry life to the surface and extremities of the body, and were 
unconscious of their danger until the morbid matter in the blood — 
precipitated perhaps by the scratch of a briar or pin, or a draft of cold 



176 THE DOCTRINE OF PURGATION. 

air or other trifling exposure — began to clot or congest in the intricate 
recesses of the brain, the liver, the pleura, oi- some other weak or deli- 
cate point, accompanied, of course, with pain or distress. Dr. Sangrado 
was then called, who proceeded at once to draw a heavy portion of the 
best blood from the system in order to relieve the suifering ; and, 
having thus paralyzed the vital forces, they were next stimulated by a 
dose of mercury and expected to perform double duty, with their 
instrument (the blood) just ci'ippled by the lancet. In other words, the 
horse that was striving, with all his might, to extricate a heavy load 
from the mire was first knocked on the head to prevent his injuring the 
wagon by his efforts, and then a shoulder was placed to the wheel in 
the vain expectation that the additional stimulus would enable the 
dying steed to drag it through the mud. The loss of the best blood 
the system conld afford neutralized the otherwise good effect of the 
mercury, gave momentary relief to the patient just so far as life had 
been obstructed, relaxed the efforts that Nature was making to dispel 
the poisonous miasma from the blood which, in its weakened flow, went 
on congesting or clotting with accelerated speed. The pain or distress 
soon returned, and again the lancet was resorted to, alternately with 
doses of calomel, until the patient's whole body, deprived of its life- 
principle, became a mass of inert and putrid matter; and "Died of 
typhus fever " was generally the verdict of Death's coroner. 

764. The practice of blood-letting has been, finally, pretty much 
abandoned, and one less revolting, but little less fatal in its operation, 
has been substituted by many physicians in its place, viz. : that of 
relieving effects at the expense of aggravating the cause by the use of 
opium. Instead of knocking the horse on the head under the circum- 
stances before narrated, his efforts are paralyzed before the shoulder is 
put to the wheel by dosing him with poison. 

765. To illustrate by another homely comparison: If a piece of 
cloth be run through water saturated with fustic, logwood, or other 
dye-wood, it will come out stained or colored. Rinse this in a brook, 
and the coloring-matter will quickly disappear ; but drop a small lump 
of alum, vitriol, or other mordant in the dye- vat before the cloth is 
passed through it, and all the water of the lakes will not sufiice to wash 
it white again. So, when the blood, by neglect, exposure, or abuse, has 
become surcharged with unhealthy matter, sufiicient to interrupt its 
healthy flow, and begins to clot or congest, a little stimulus applied in 
the same direction that the law of our nature is already striving to 
impel the vital forces^ will enable them to dislodge the congestion and 
expel the morbid matter from the blood. But introduce an opium pill 
or the smallest portion of morphine into the blood, and all the mercury 
or other cleansing stimulants on earth will scarcely purge it clean. 

766. A bullock's hide once accidentally lodged on a shoal (weak 
point) in the River Tiber — the great artery of Rome. Against this the 
impurities and drifts of the river gradually congested^ until it became a 

ast-anchored island. When first deposited it is probable a housewife 



THE DOCTRINE OF PURGATION 177 

might, with a mere swash of her broom in the direction of the cm-rent, 
have so far stimulated its force as to have removed the hide (congestion) 
and prevented the formation of the island. 

767. Before applying such a mercv/rial remedy, to be consistent 
with his practice as applied to the cleansing the channels of the blood, 
Dr. Sangrado would have first withdrawn from the Tiber sufficient 
water to have left the bullock's hide high and dry in the sand, and then 
set the woman to work with her broom ; whilst Dr. Morphina should 
have advised that the swashing process should be deferred until the 
waters of the river were congealed by frost, or thickened by some 
ingenious process to the like consistency imparted to the blood by opium 
or other narcotics. 

768. What I have said so far is mostly theory^ which readers will, of 
course, estimate at what it is worth. What I am now about to say is 
fact^ derived from more than thirty years' observation and experience 
applied to multitudes of cases with, as far as I am advised, uniform 
success, including bilious colic, bilious fevers, and all that class of mala- 
dies that, under the ordinary medical treatment, end in slow fevers 
called in the books Typhus or Typhoid, Pleurisy, common colds and 
sore-throat. Indigestion, and its first-born child Headache, Croup (if ap- 
plied in an early stage). Dysentery, Diarrhoea, Fever Sores, and running 
sores generally (the fountain of which is ever the blood), cuts and bruises 
of the flesh (if applied immediately after the accident occurs), and, in 
fact, almost every acute ailment common to our climate, that commences 
with pain in the head, body," or limbs, or at the commencement of which 
the patient remarks, in a languid tone, ''^ I donH feel well^^ with the 
exception, perhaps, of scarlet and lung fevers, which the remedy I shall 
describe greatly benefits, and lays the foundation for a certain cure, as 
far as my limited experience in these complaints extends, by applying 
additional simple treatment, viz., joi^Mng in the former, and certain 
vegetable cordials or decoctions in the latter complaint. 

769. At a period when the reputation of the hlood-leWlng physician 
I have referred to was at its height (and it was great in proportion to 
the scores of his victims that died, those that recovered being held in 
popular estimation that his skill had miraculously rescued from an other- 
wise mortal distemper), a hired girl living in my father's family was 
smitten with the usaal symptoms of the prevailing malady, ajid Doctor 
Sangrado was sent for. He told my father that the girl's case was ex- 
ceedingly dubious, that her organization was unfavorable, and that he 
had but little hopes of her recovery ; still he would do all that medical 
skill could do to save her life. My father was opposed to blood-letting, 
and the doctor deferred the use of the lancet until the next day. In 
the meantime my father gave the girl a dose of what was then known 
as AldricNs Pills, accompanied with a sweat. The next afternoon the 
doctor called again, and, after sitting a little while, inquired after the 
girl's health. My father told him what had been done, and that she 
was then apparently well and at work in the kitchen. Upon this an- 
nouncement the doctor mused a few moments, and after remarking in 
a soliloquizing tone that " those pills are devilish things," he took up his 



178 THE DOCTRINE OF PURGATION. 

saddle-bags, lancet, blue pills (sure to be followed by rheumatism), 
opium, mercury, blisters and all, and departed, " never to retumP 

T70. About this period manufacturers in the town alluded to, of 
which I was one, were seriously incommoded by the annual prevalence 
of the complaint, dubbed by Sangrado as typhus, but popularly known 
2L^fall fever. Business was sometimes brought nearly to a stand-still 
from the number of hands that were taken out of employ in consequence 
of long, and, in very many cases, fatal sickness. A young man or 
woman would leave the mill, complaining, perhaps, of a pain in the 
head, iieek, shoulders, back, or side, or difficulty in breathing, send for 
Doctor Sangrado, experience momentary relief from the free use of the 
lancet, and, in consequence, be prostrated on a bed of languishing for- 
weeks or months, and probably die. I was fully satisfied, in my own 
mind, that both the sicknesses and deaths were, in a great majority of 
cases, the result of improper treatment, rather than the normal character 
of the malady, and greatly to the disgust of Dr. Sangrado, gave free 
and wide utterance to my convictions. I finally resolved to practice 
medicine myself, so far as I could obtain patients, from among those in 
my immediate neighborhood and employ, gratis ; and from that day to 
this, a period of more than thirty years, out of many hundreds of cases 
of almost every type of disease, I have never known a death to occur 
among those who have relied solely on the simple remedies I have fur- 
nished, nor have I known of a serious case among them all of Dysentery^ 
Pleurisy^ Typhus or Typhoid^ Brain^ Congestive^ Bilious^ or any other 
fever, except scarlet or lung fevers, of which last, as before said, my 
experience has been slight, and confined to my own family, in which 
there has been five cases of scarlet fever ; one of which was treated by 
two of the most renowned physicians in New York, and died in great 
apparent agony on the seventh day. Two of the other cases were 
equally severe, but all recovered without the interference or aid of the 
faculty. -|. 

771. For some time I relied on the " devilish pills ^' only in lighb at- 
tacks, and gave from 12 to 15 grains of calomel, with a good sweat in 
severe cases. I generally attended to the sweating process (which I shall 
hereafter describe) myself; and never, to my recollection, failed to obtain 
the desired sweat. The mercury stimulated the interior powers of the 
system, whereby the morbid matter is (as I suppose) forced from the blood 
into the bowels, and thus passes off; whilst the sweat, operating on the 
external pores of the body, in like manner as the stimulating mercury 
acts on the internal pores or ducts, the two forces sympathize and assist 
each other ; and the congestion and other causes of disease (unless it has 
become chronic) are wholly expelled at one operation, leaving the system 
as free from poisonous or unhealthy matter as is that of a new-born 
babe. 

772. It is now nearly thirty years since I entirely abandoned the use 
of calomel, for which I substituted " Brandreth^s Pills^'' which I have 
found, after long and varied experience, produce all the good effects of 
mercury, with none of its bad. Too much care cannot, however, be ob- 
served in obtaining them, as a large proportion of the pills sold in N^ew 



THE DOCTRINE OF PURGATION. 179 

England are spurious, notwithstanding their close resemblance to the 
genuine and the oaths of the unprincipled men who vend them. To 
make sure of the genuine, I always obtain them from Dr. Benjamin 
Brandreth's own office, which is at the " corner of Broadway and Canal 
Street, New York," and who sends them to order, free of charge for ex- 
press, for two dollars per dozen boxes. One or two boxes (or not over 
twenty-five cents' worth) sufficing generally to keep a family of ordinary 
size in Health for a year. 

773. Thus any man, by an expenditure of two dollars, may keep his 
own family, and those of some five or six of his neighbors, in health for 
a year, and that with very little if any loss of time, and not a farthing's 
expense for medical aid. This, as a general rule, I pledge my word I 
know to be true by actual practice and observation — although 1 suppose 
it will not be so regarded by most readers. These pills are as efficacious 
in cases of hurts, bruises, cuts, sores, &c., as in other maladies. By im- 
mediately cleansing the blood they remove all danger of lock-jaw, fester- 
ing sores, or congestion of the blood, at the wounded or ailing points — 
and nature speedily restores the injured parts. N^ot unfrequently, from 
the use of opium in some of its varied forms, or other malpractice, the 
morbid matter in the blood seeks to escape through vents called fever- 
sores. I have known instances of this kind wherein, after the patient 
has been in acute pains for weeks, a few doses of Brandreth's Pills have 
turned this current of morbid matter from the sores to the howek, 
through which it has been passed off, and the patient healed almost at 
once. But I do not mean to be understood to say that this is the rule ; 
as when the system has been surcharged and weakened by poisonous and 
stupefying drugs, nature's vital forces cannot always be rallied by any 
treatment that I am acquainted with. 

774, I will close this long (and, as doctors will doubtlessly say, ab- 
surd and foolish) article, with a simple recipe, which, if adhered to in all 
its requirements, I know will heal at one operation a great majority of 
the ills we are liable to in this country, and I believe in all other coun- 
tries. 

776. I know that it has been used with entire effect in cases of yel- 
low fevers ; and I now have in my possession a certificate, signed by 
every member of a company who were nine months in the Army of the 
Potomac, at a time when thousands were dying around them with 
small-pox, and swamp fevers, and dysentery — the health of every one of 
whom (without an exception) was preserved, without the aid of a physi- 
cian, simply by relying solely on " Brandreth's Pills," a quantity of which 
had been presented to the Company, with directions for using them, by 
their fellow-townsman, Dr. Benjamin Brandreth. 

KECIPE. 

776. In cases of slight hurts, cuts, bruises, punctures, &c., or slight in- 
disposition, take from one to six Beandketh's Pills, according to age and 
constitution ; say one pill for a child one year old, two for a child of 
three years old, and four or more for adults. 



180 THE DOCTRINE OF PURGATION. 

YY7. AYliere any malady lias made such progress as to cause difficulty 
of breatliing, oppression, or severe pain in any part of the body, head or 
limbs, place the feet of the patient in water as hot as it can by any pos- 
sihUity be borne, and throw a blanket over the knees to keep in the 
steam. Do not let the feet remain in the bath to exceed four minutes, 
Wipe the feet dry as quickly as possible, and rub them hard v\^itli a dry 
towel. Then get at once to bed, and take from one to six pills as above. 
(In cases of intense bilious colic or pleurisy, give six, eight, (5r even 
more, until relief is obtained, but by no means attempt to remove the 
pain at the expense of the life by blood-letting or narcotics.) After 
swallowing the pills, drink a glass of weak lemonade (or molasses and 
water, if lemonade is not to be had) made almost boiling, and so hot that 
it can only he taken in sips / then cover warm and a sweat will shortly 
ensue. This treatment will set all the vital forces of life to work, both 
internal and external, and not only remove the effects but the cause of 
the distemper, as the most ignorant cannot fail to perceive, not only by 
the relief that will be experienced, but from the offensive character of 
the matter that passes from the bowels, a large portion of which proceeds 
from the blood, liver, or other vital intestines. Water-gruel alone should 
be taken for eighteen hours after taking the pills, after which, as far as 
my experience has extended, patients, as a general rule, will be restored 
to complete health, and in a situation to eat and exercise as usual, with- 
out danger of relapse, for the simple reason that the blood, the seat and 
organ of life, is freed from all impurities, and consequently there is 
nothing in the system to cause a relapse ; nor can sickness again ensue 
until the blood again becomes surcharged with extraneous and morbid 
matter. 

T78. Some readers may possibly suppose that, in accordance with 
general usage, I may have some interest other than that of a desire for 
the good of others in recommending " Brandreth's Pills " (which, by the 
by, are always inclosed in a certificate and directions folded around each 
separate box, with a government stamp on the envelope). For the benefit 
of such readers I will just say, that I have never received from Dr. 
Brandreth or any other person a farthing for anything done by me in 
relation to his pills ; that I have always paid full price for every box I 
have had ; that I have never received a farthing for any disposition I 
have made of them, although I have probably administered and given 
away hundreds of boxes — that I esteem a judicious distribution of them 
in a charitable point of view as of more value than an hundred-fold of 
the same value bestowed in money ; that in case of leaving my family 
for any considerable season, I should do it with an easier mind if satis- 
fied that they would on any and all occasions — of accident or disease — 
resort to the foregoing prescription for cure, than I should were they left 
in a position to command the best medical advice (apart therefrom) in 
the world ; and this assurance has beQ^ derived from a long and varied 
experience, that has fully satisfied me that there is no necessity that one 
life should be lost in New England, where there is now ten by what is 
called Typhus or Typhoid Fever — which, in fact, as a general rule, is but 
the ebbing away with a slow fever of the life from the blood in conse- 
quence of the impurities it is forced to consort with, first engendered by 
breathing foul air, gluttonous and hasty feeding, and other causes and 



THE DOCTRINE OF PURGATION. 181 

exposures, and subsequently aggravated by the malpractices of physi- 
cians — among the most prominent of which was the former practice of 
bleeding and parching to death with thirst, which practices were only 
abandoned by the faculty in consequence of an outside popular pressure, 
since which morphines and other narcotics have been substituted for the 
lancet with almost equal fatal effect, and which will be doubtlessly per- 
severed in so long as ignorant patients measure the doctor's skill by his 
ability to reb'eve effects at the expense of aggravating the disease, instead 
of working them off by removing their cause. 



! 



APPENDIX. 






CUEES BY PURGATION 



Cure of Abram Van Wart, of Sing Sing, of Bright's Disease of the 

Kidneys. 

Sing Sing, Oct. 14th, 1863. 
Dr. Brandreth, 

My Dear Sir: I was taken sick two years ago with a most severe 
pain in my right arm and elbow. Dr. A. K. Hoffman, of this place, pronounced 
it neuralgia. He treated me for some time, but getting no better, advised 
electricity ; I consented, but the shock nearly killed me, and I received no ben- 
efit whatever. After this my legs became numb and paralyzed, and my back 
and kidneys were tormented with most intense and continued pain. Dr. A. K. 
Hoffman and other physicians told me J had Bright's Disease of the Kidneys. 
They treated me for a long time, but finally pronounced my case hopeless. 
Other eminent physicians then treated me but did me no good, and gave my 
friends to understand that my case was incurable. So, at length, I gave up all 
hope, the lower half of my body being totally paralyzed and much swollen ; 
and I suffered terrible pain in the upper part of my body. My bowels were 
completely constipated from the paralysis, and no medicine produced a passage, 
and my urine was full of albumen. This was my condition five months ago, 
when my wife's sister, Sally Ann Storms, begged me to take Brandreth's 
Pills, as she had used them herself and in her family for many years with the 
best effect. Induced by her and my wife, I swallowed nine Brandreth's Pills. 
They operated twelve hours afterward, slightly. I continued taking nine every 
day for several weeks, their operation constantly improvi.ng. Finding myself 
a great deal better, I diminished the dose one pill a day, until I got to five. 
One afternoon, at 3 o'clock, about three months ago, I took five pills ; at 9 they 
commenced operating vigorouslj: ; suddenly I felt as if something gave way 
inside, and the stools were like egg and water mixed, several quarts of which 
came away, of a most disagreeable odor. The next day I felt very faint, and 
my neighbors came to see me die ; but as soon as the faintness passed I was 
much better, and, for the first time in nearly two years, I was able to move and 
stand ujpon my legs. I continued taking the pills, and, in a very few days, was 
able to walk across my room, and now am able to walk quite a distance. I 
have taken altogether nineteen boxes of Brandreth's Pills, and now one pill a 
day is all I require. My health is nearly restored, my appetite is good, and I 
suffer hardly any pain anywhere, and every day I grow stronger. My neigh- 
bors look upon me as one risen almost from the dead, and I desire you to pub- 
lish my case, that those suffering from paralysis and kidney diseases may know 
how easily they may be cured by Brandreth's Pills. 

ABRAM VAN WART. 



184 CURES BY PURGATION. 



We, neighbors and relatives, certify that the foregoing statement of Abram 
Van Wart is true. 

A. B. REYNOLDS, Supervisor of the Town of Ossinioig. 

DAVID McCORD, Ex-Loan Commissioner. 

J. MALCOLM SMITH, Justice and Clerk Board of Supervisors. 

ABRAM HYATT, United States Assessor, Tenth District. 

JAMES McCORD, Loan Commissioner. 
RACHEL CYPHER, RACHEL ANN SLATER, 

WILBUR F. FOSHAY, LETITIA VAN WART, 

SARAH A. CYPHER, WM. SNIFFIN. 



The Methodist Society have heard the above facts stated in meeting from 
the mouth of Mr. Van Wart. 

Mr. John Archer, Ticket Agent at the Hudson River Railroad Station at 
Sing Sing, permits reference, he being fully acquainted with Mr. Van Wart and 
all particulars. 



In Epilepsy Brandreth's Pills Seldom Fail 

to cure, because they purify the blood. If we are sick from' any cause we owe 
it to ourselves to use this remedy which Providence places within the reach of 
all. 

New York, July 8, 1861. 
Dr. Brandreth, 

Sir : A boy of mine was subject to fits from his infancy — his case was con- 
sidered hopeless by the doctors, who thought he would be subject to them for 
life. After they had given him up, I was recommended to try your Pills, and 
without much faith did try them, using them according to your printed direc- 
tions. Four years ago I commenced giving them to him, and to my great joy 
and relief he has had but one return only of his affliction since. I consider 
him now perfectly cured. 

The extraordinary benefit they did him makes me always recommend them 
to my friends, and I would be glad if everybody knew their value. The cause 
was the worst possible ; he would have been helpless and almost uselessly unfit 
for any kind of business from the length and severity of each attack — often 
lasting a whole night, and leaving him, for two or three days afterwards, en- 
tirely prostrate from weakness. Every kind of treatment was also externally 
applied that was professionally advised. You may, therefore, judge what good 
reason I have for letting you have this statement in acknowledgment for the 
benefit received, and for the purpose of letting those who may be hesitating 
under similar circumstances have my testimony in confirmation of the relia- 
bility of the other certificates, and perfect confidence like myself in the value of 
the Pills. 

Yours respectfully, 

JOHN WEBB, 

18 BeeTcman Street. 



CURES BY PURGATION. 185 

Letter from General Paez, the Washington of Venezuela, 

in favor of Brandreth's Pills. 

New York, May 30, 1865. 
Hon. B. Brandreth, 

My Dear Sir : I have received the supply of your invaluable Pills which 
you have so kindly sent me. I have not only used them myself in South 
America, as well as in this country, for the last thirty years, never allowing 
myself to be without them, but have purchased them by the gross to distribute 
to persons upon my estates and- elsewhere, having found them efficacious in 
almost every variety of disease, especially those peculiar to the Southern con- 
tinent. I esteem, therefore, very highly the supply you now send me, and 
thank you very cordially for the kind words in which you convey your generous 
and friendly sentiments. 

I am, very respectfully, your obedient servant, 

JOSE A. PAEZ. 



Debility and- Costiveness Cured. 

This certifies that I have used Benjamin Brandreth's Vegetable Universal 
Pills more than three years, and I do affirm that having used a great deal of 
medicine of various kinds I have found none so beneficial to my health as the 
above-mentioned pills. 

I have been unhealthy from a child, and have had the advice and attention 
of the most eminent physicians, who did for awhile alleviate my sufferings, but 
at last their skill proved unsuccessful, and I was sinking into rapid decay, given 
up by my physicians, and bending over the tomb without a jot of a prospect 
for recovering. While in that condition a friend recommended Brandreth's 
Pills to me. I sent immediately and got a box, and the first dose gave me so 
much relief that I repeated it, and after several doses, finding my health im- 
proving, I continued to take them two or three times a week for twelve months. 
At the expiration of six months I thought that my health was perfectly restored, 
but still my bowels were irregular and dormant, so I continued to take them as 
before, until the expiration of six months more, when I found, by gradually 
quitting, I did not need them more than once a month ; and since I betook my- 
self to the use of Dr. Brandreth's Pills, I have had no need of a physician, 
except in two cases, both of which needed skill more than medicine. 

During the first year after I commenced using these Pills I was very cau- 
tious both in the quality and quantity of my diet, but since that time I have 
generally eaten what was set before me. The Pills are the mildest in their 
operation of any medicine that I have ever taken ; they also produce the most 
powerful and free discharges of any medicine that I have ever used. And I 
speak from experience, that continued use will not render them ineffectual in 
their operation. If I take a dose and they do not operate, I continue to take 
them, increasing the number of Pills in each dose, until powerful discharges 
ensue without any pain, and in a few hours I feel perfectly well and able to 
attend to business. 

Having derived so much benefit from the use of Brandreth's Pills, I would 
recommend them to all who are sick, whatever may be their diseases or com- 
plaint; for it is manifest that nothing is more important in any case of 
illness than to keep the bowels regular, and it is also evident, in my own opin- 
ion, that no better medicine than Brandreth's Pills can be obtained to keep the 
system in a healthy condition. 

R. DUNN, 
No. 22 Third Street^ Cincinnati. 

June 1, 1860. 



186 CURES BY PURGATION, 

Remittent Fever, of the Island of St. Thomas, Cured by Bran- 

dreth's ?\\h. 

New York, May 31, 1856. 
Dr. Benjamin Brandreth, 

Dear Sir : It seems to me to be a duty to say tliat, when I was United 
States Consul at St. Thomas, in 1849, I used your Pills with very great advan- 
tage. I was taken with the fever peculiar to that island ; the doctor bled me, 
and I was in very great danger of dying from that fever and the depleting. 
The inward fever was so great that no quantity of drinks seemed to relieve it. 
I was considered in very great danger, and I felt that my hold of life was really 
very feeble. In this condition I was recommended to use your pills. I at once 
took eight. Their effect was surprising. They seemed to be actuated by intel- 
ligence. I could feel them searching all round my stomach, even up to my 
throat ; every recess of the body was aroused to action. I continued to use 
them daily until I had taken two boxes, containing twenty-five pills each, when 
I was quite recovered to my usual health. 

Governor Oxholm expressed to me the opinion that the Brandreth Pills 
were the best medicine he had ever known "^ that he entirely relied upon them 
when he or his family were sick. He would not be without them for any 
money ; that he believed you had been the means, by introducing them, of 
saving many valuable lives — a sentiment m which I concur most cordially. I 
desire, rhy dear Doctor, if you deem the above of any service, you will not be 
afraid to publish it. 

I am, very truly, your friend, 

• CHARLES H. DELAY AN, 
Late United States Consul for the Island of St. Thomas, West Indies, 



Cure of Dyspepsia of Ten Years' Standing by Brandpeth's Pills. 

BusHwiCK, Kings Co., L. I., March 1, 1843. 

This is to certify that I was taken ill during the season of the cholera, in 
the year 1832, and continued ailing until the spring of 1842, during which time 
I was severely troubled with dyspepsia, and all its various train of suffering. 
I became extremely emaciated, melancholy, and worn out with suffering, so 
that life itself seemed burdensome. I, in the meantime, applied to a number 
of the best physicians, who prescribed for me ; and many were the bitter doses 
of medicine that I took, but without avail. At last I yielded to despair. The 
idea of taking the prescriptions of physicians any longer was useless, and I was 
bitterly opposed to taking pills. My friends became alarmed ; often solicited 
me to try Brandreth's Pills, asserting that they had derived great benefits from 
their use. At last I was tempted to give them a trial, and it is but just to say 
that, after using them a short time, I began to recover, and soon was entirely 
restored to health : and I think it a duty I owe to the world, and to Doctor 
Brandreth, to make this public acknowledgment. 

N. BLISS. 

Mr. Bliss will be pleased to testify as to the merits of Brandreth's Pills, 
after an acquaintance with them of twenty-three years. 

July, 1866. B. B. 



CURES BY PURGATION. 187 

Cure of Consumption and Dyspepsia. 

" IIammonton, New Jersey, May 7th, 1866. 
" Dr. Brandreth, 

" Dear Sir : I have long wanted to write to you and express my gratitude 
for the beneficial effects that have been experienced in my own family, and in 
hundreds, aye, thousands of others, by the use of Brandreth's Pills. The first 
year my lamented friend Brockway sold your pills in Boston (1838) I called at 
his office. I was then in a declining state of health, and my fri'ends, as well as 
myself, supposed my earthly voyage would soon terminate. Mr. Brockway 
urged me to take the Brandreth Pills, but having used so much medicine, with 
no good effect, I was more inclined to let nature take its course, and calmly 
submit to my fate. Mr. B. offered to give me one dozen boxes if I would try 
them as prescribed. By this I saw he had great faith in them, and I finally 
consented to take them, but not as a gift. I went home and went at it, almost 
hopelessly. After taking one box 1 began to feel better. Well, sir, when I 
had used up my twelve boxes, I was apparently a well, healthy man, my weight 
having gone from 131 pounds up to 152 pounds. I then ordered a supply, and 
between that time and the present I have retailed three thousand dollars worth 
of these invaluable pills, and am quite sure that I have thereby been instru- 
mental in saving, not hundreds, but thousands of lives. I have given them to 
my oxen, horses, pigs, fowls, cats, dogs, and always with the desired effect. I 
have a wife and nine children, most of them born since I have used the pills. 
A more healthy family cannot be found. We are frequently asked how it is 
our children look so healthy. My wife replies that ' We raise them on Brand- 
reth's Pills.' Now, my children overload their stomachs, get cold and out of 
order, like others, but they have been taught the remedy, and go and take the 
pills of their own accord. This I consider an important branch of their educa- 
tion, and feel assured, as they shove off upon the voyage of life, that they 
know how to take care of themselves. I was in trade at my last residence, 
North Lincoln, Me., for 29 years. I have been here about seven years ; I am, 
therefore, well known, and my statements can be verified by hundreds. 

" Yours. 

" C. J. FAY, P. M." 



Certificate of Twenty-eight Years' Use. 

Newcastle, Westchester Co., N. Y., Aug. 11, 1861. 
Dr. B. Brandreth, 

My Dear Sir : I am now seventy -nine years old, and for the last twenty- 
eight years have been a constant user of your Vegetable Universal Pills when 
sick, fully realizing the advantage of enforcing purgation with a medicine, 
which, while harmless in its nature, removes all impurities. I can safely say 
that the vigorous old age I now enjoy has been caused mainly by the timely 
use of Brandreth's Pills. I have had, in these last twenty-eight years, several 
fits of sickness, and occasionally some infirmity of age would press upon me. 
At these times I have always found your Pills a sure remedy, giving me not 
only health but strength. I consider them, therefore, invaluable as a tonic, 
with qualities possessed by no other medicine known to me. I have never, 
during these last twenty-eight years, used any other medicine whatever, being 
convinced, by experience, that none was as good. Brandreth's Pills have also 
been freely used by my neighbors in every kind of sickness, and have never 
been known to fail when promptly administered. 

Yours truly, 

NATHANIEL HYATT, 
Justice of the Peace for Forty Years in Westchester County, N. Y, 



188 CURES BY PURGATION. 



A Man Saves His Leg. 

Sing Sing, Westchester Co., N. Y., Aug. 24, 1860. 
Dr. B. Brandreth, 

Dear Sir : Some years since a bad swelling appeared on my knee, and sev- 
eral physicians attended me. I kept growing worse and worse, until I was 
confined to my bed, a helpless cripple. Large quantities of matter kept 
coming from my leg, from six deep holes, together with pieces of bone. I lay 
in bed over one year, when the doctor came to me and said I had a very bad 
white s^^£elling, and that the leg must be cut off or I would die. - They wanted 
to cut it off then, and had brought all their instruments. I said, " No ; I 
would die first." So they left me. Despairing of cure, I took your pills. I 
began wath four a day, and took them every day for a month, when my knee 
appeared a little better. This encouraged me, and though still in bed, I con- 
tinued taking your pills for four months more. I was now able to get up and 
go about a little with a crutch. I used the pills for three months more, when 
the sores all healed, and pain ceased, and I was well. I threw away my crutch, 
and now for the last four years I have been a well and healthy man, my leg 
being strong and my body sound. Words fail to express my gratitude to 
you. 

Yours truly, 

RICHARD T. BAKER. 
Westchester County, ss. : 

Richard T. Baker, being duly sworn, says, that the foregoing statement of 
his cure by Brandreth's Pills is true in every particular. 

RICHARD T. BAKER. 
Sworn before me, this 24th ) 
day of August, 1860. j 

A. Jackson Hyatt, 

Justice of the Peace. 



Dyspepsia Cured. 

" Bennington, Vt., Dec. 5th, 1«43. 

" Dear Sir : I wish you to add my testimony to the host of others that 
you have in favor of your valuable pills. In the year 1838, I was attacked 
with that disagreeable complaint, the dyspepsia, which so affected me that I 
could not take the least particle of food without the most unpleasant and un- 
comfortable sensations in my chest, head, and bowels. My chest was so sore 
that I could not bear the slightest pressure without giving me pain. My health 
was most miserable ; many physicians told me they thought I was in the con- 
sumption, and that if I did not give up my business, and change climate, I 
could live but a short time. 

" I tried everything in the shape of medicine, and consulted the most skilk 
ful physicians, but found no permanent relief. I became discouraged, gloomy, 
sad, and sick of life ; and probably, ere this, should have been in my grave, 
had I not fell in with your precious medicine. A friend of mine, who had been 
sick of the same complaint, advised me to try your pills : but, having tried 
most other medicines without obtaining any relief, I had but little faith that 
your pills would be of benefit to me ; but at his earnest solicitation, I pro- 
cured a box and commenced taking them. 

" The first box produced little or no effect, and I began to despond, for fear 



CURES BY PURGATION. 189 

that your medicine would prove like others that I had taken ; but my friends 
urged that one was not a fair trial, and I purchased a second, and before I had 
taken the whole box I began to experience a change ; the pain in my chest began 
to be less painful, and my food did not distress me as much as formerly. I 
went on taking them until I had taken six boxes, and my Dyspepsia was gone, 
and my expectation of an early death vanished, and I felt like a ' new 
CREATURE.' I was then, and am now, a healthy man ; I have never since been 
troubled with Dyspepsia. I have administered your pills to the members of 
my family, and to my friends, and in all cases with good success. You can 
publish this if it will be of any use to you. 

" I am, dear sir, truly yours, 

"J. L. COOK, 
" Publisher of the State Banner. ^^ 



Remarkable Case In which Fifty-two Pills were Used before the 
Bowels were Opened. 

John Pickett, living at 553 First Avenue, New York, aged 27, of robust 
constitution, from a severe wrench was laid up. His back pained him as if the 
muscles were torn. His bowels, kidneys, and bladder seemed paralyzed. For 
seven days nothing passed his bowels, spite of all the remedies administered 
by his three doctors, who told his wife they could do no more, and he would 
die. She was advised, as a last effort to save him, to give him Brandreth's 
Pills. So she procured a box, and gave him four pills every four hours. She 
rubbed the pills down to powder under a knife on a plate, and then mixed with 
molasses. She continued this treatment until she had administered fifty-two 
pills, when they operated, and the man's life was save*d. 

Observation Particular in respect to above Case. 

It is right here to call attention to the fact that while, in the first instance, 
this great quantity of Brandreth's Pills were required to produce a thorough 
cleansing of this man's 



PARALYZED BOWELS 



two pills every day thereafter were all-sufficient to keep them open until his 
health was established. 

Thus we see how important a medicine Brandreth's Pills are ; suitable for 
the most trying emergencies of bodily affliction, as for the most simple disorder. 
Always safe yet always sure. 

They are indeed a century in advance of all other purgatives. 



Fever and Ague Cured. 

Mr. John Y. Haight, Supervisor of New Castle, Westchester County, New 
York, desires the attention of those interested. He says : " I was, about two 
years ago, attacked with fever and ague, which, notwithstanding the best medi- 
cal advice, continued to sorely afflict me for six tedious months ; I became yel- 
low as saffi:-on, and reduced to skin and bone. Medicine and physicians were 



A90 CURES BY PURGATION. 

abandoned in despair. As an experiment, I concluded to try a single dose of 
ax of Brandreth's Universal Vegetable Pills on an empty stomach, early in the 
morning. The first dose seemed to arouse all the latent energies of my ex- 
hausted frame. Their purgative effect was different from anything I had ever 
used or heard of. At length this effect ceased, and I seemed lighter and 
breathed freer. That evening I was indeed sensibly better and slept soundly 
all night. The next day I followed the same course and took the same number 
of pills. I continued to take the pills in this way about three weeks, when I 
found myself entirely cured. It was two years ago, and I have had no return. 
My health has been surprisingly good, and I have used no medicine since. 



Mr. Carpenter, of Gouverneur, New York, sixty-four years of age, says 
he has used Brandreth's pills for thirty-four years ; administered them first to 
his coachman, who had Fever and Ague ; gave eight the day after the chill ; 
chill and fever less severe ; gave eight more the next day, and so every other 
day, until the chill and fever did not return, which was in about eight days 
from the first attack. He then gave four every other day another week, when 
the man was entirely restored to his usual good health. 

He was himself attacked, took them in the same way, and was cured in less 
time; has used no other medicine for thirty-four years; found them always 
every way reliable for himself and for his family when sick ; has recommended 
them to thousands with the best results ; feels confident that every family 
would have a larger average of health if these pills were used in the place of 
calomel and other hurtful remedies. 



The following is an extract of a letter from Hon. Caleb Lyon, of Lyons- 
dale, DOW Governor Lyon of Idaho, to Dr. Brandreth : 

"My sincere thanks are due you for the boxes of Brandreth's Pills that you 
were so kind as to send me previous to my departure for the East ; and a more 
efiicient medicine as a preventive of disease upon the miasmatic shores of the 
Danube, or the plague-stricken cities of Egypt and Asia Minor, I do not believe 
was ever used. My whole party took them freely, and while others were ill 
and delayed, we kept well. Enclosed you will find the translation of a letter 
from Achmet Hallilla, an Arab Sheik, to whom I presented several boxes. 

" ' Peace be unto you and length of days ; thy medicine (Brandreth's Pills) 
was a fierce foe to Azrael, both in pestilence and caravan sickness ; the little 
orbs were rich with the wine of health ; let the maker wear this golden circle, 
that he may know I was wounded with the arrows of disease, but am now 
healed. 

" * May he grow in the sunshine, and dispensing blessings be the most blest. 
(Signed) " ' ACHMET HALLILLA.' " 

Brandreth's Pills are both sugar-coated and plain. 



Paralysis of the Legs, of Seventeen Years* Duration, Cured by 
Brandreth's Pills Alone. 

JExtract of Consul Graham^ s Letter to Dr. Brandreth^ on file at 394 Canal 

Street. 

General T. has a brother over forty years of age, whose legs have been 
paralyzed for seventeen years, so that he could not walk a step. He has tried 
all sorts of remedies, and been under the care of various physicians, all of 



CURES BY PURGATION. 191 



whom have pronounced his case incurable. I gave my friend a box of Bran- 
dreth's Vegetable Universal Pills, with the printed instructions ; his brother 
took them, and was so pleased with the effect that he ]>ro vailed upon Messrs. 
Zimmerman & Frazer to let him have a few dozen bo\e ;, He has now taken 
some thirty or forty boxes, and is so far recovered that he can walk with a 
CANE, and has full faith that he will recover entirely. He is so enthusiastic in 
favor of the pills, that he has cut your likeness from some of the package-labels 
and has posted it over his table, and frequcnll/ burns a candle before it (he is 
a Catholic) ; and when his friends come in he points to it, saying that this is 
the true "saint," ^^ my saint; all the rest I value nothing in comparison." 
This gentleman entirely recovered the use of his limbs, and is now one of the 
healthiest and soundest men in Buenos Ayres. 



Captain Berry, formerly of the New York Custom House, had also lost the 
use of his legs, and was obliged to use crutches. He resorted to Brandreth's 
Pills ; three months' vigorous use cured him of his rheumatism entirely. 



Cancer Cured. 

Mary H., wife of L. D. Grosvenor, of the United Society, Harvard, 
Mass., was cured of a cancer of many years' standing. " The prospect of ter- 
minating my life by the ravages of that insufferable scourge of humanity, the 
cancerous tumor, was certainly prevented by the timely and persevering use of 
Dr. Brandreth's Medicine, and a wonderful cure effected," 



Isaac W. Briggs, of 145 Suffolk Street, New York, says he has used Bran- 
dreth's Pills for thirty years, having commenced to use them in February, 
1836, for dyspepsia and affection of the kidneys. He took Brandreth's Pills 
every day for thirteen months, and in March, 1837, became a perfectly sound, 
healthy man. Mr. Briggs will be pleased to answer any questions on this 
subject. 

July, 1866. 



United States Sanitary Commission, ) 

Wethersfield, Wyoming County, N. Y., June 27, 1865. j 
Doctor Brandreth : — This certifies that I have used your celebrated Pills 
for over twenty years, personally and in my family. When we are sick, in- 
stead of sending for a doctor, we use Brandreth's Pills. I believe if every one 
would adopt the same course, the doctors would have but little to do. I have 
traveled in fifteen States, and been in the army sixteen months, and necessarily 
exposed to much disease, yet by the use of your Pills occasionally, have secured 
my health through the biting winter's frost and the scorching summer's heat. 



192 CURES BY PURGATION. 

In fact, Doctor, I feel, with your Pills in my pocket, safe from the attacks of 
disease. They seem to cleanse the blood and regulate the system, whether it 
be troubled with dizziness, diarrhoea, or costiveness. When out of sorts, I use 
them, and they always cure me. I would not be without them for four times 
their cost. 

I send this to you that others who know me may profit by it, wishing to do 
good to my fellow-beings. 

N. HIGLEY. 



Dyspepsia and Costiveness Cured. 

D. J. TENNY'S CASE.— iV^e?^ York Mentor, January 14, I860.— 
Whether the Brandreth's Pill is ever convertible into blood we will not now 
discuss. But our chief object at this time is to give a statement of a gentleman 
who says he has taken one of the Brandreth Pills for at least sixteen months, 
daily, or about 480 days in succession, and who says that at the end of that 
time he considered himself cured of Dyspepsia, attended by a constant costive 
state of the bowels, which had troubled him for a long time. 

This gentleman, Mr. Daniel Tenny, resides at the Astor House, in this city, 
and has been in the enjoyment of excellent health ever since he was cured by 
this treatment. He is an intelligent man, and there is no doubt of the truth of 
his statement. This proves, at least, that as many as one of the Pills prepared 
by Dr. Brandreth can be taken for nearly 500 days in succession without harm, 
and at the end of that time a dyspeptic and costive habit of body may be per- 
fectly cured. This could not be said of any of the cathartics in use by those 
who style themselves the Begular Faculty. 



Asthma Cured by Dp. Brandreth's Pills. 

The following cure of Asthma by the use of Dr. Benjamin Brandreth's 
Pills is authenticated by seventeen well-known respectable citizens of Green- 
wich, Conn. : 

This will certify that Thomas S. Brown, who had been for some time pre- 
vious much affected with asthmatical symptoms, was taken suddenly worse on 
the 12th of June last : he began to cough and raise phlegm, and in the course 
of twenty-four hours expectorated nearly two quarts of thick white jelly-looking 
matter. Three physicians pronounced it a nervous humid spasmodic Asthma, 
and after prescribing for some time, to no effect, the three consulted together, 
and finally declared that they could do him no good ; it would and must result 
in consumption, and death would ensue, and that in a very short time. The 
pain was excessive in all parts of his body ; and the difficulty of breathing was 
such as almost to cause strangulation. He was reduced to a mere skeleton, 
and finally gave himself up to death. After being in this miserable state nearly 
two months, he saw an advertisement of Dr. Brandreth's Vegetable Universal 
Pills, and immediately sent by Captain J. Waring, of Greenwich, for a 25-cent 
box, and found relief in the course of a few days. It is proper to say that he 
commenced with two pills at night, and two in the morning ; he found relief the 
second day, and encouraged thus to persevere with larger doses, he was soon 
able to sleep comfortable, and now, having taken them for about four months, 
according to the directions, is entirely recovered, and so far as we tan judge, 



CURES BY PURGATION. 193 



entirely in consequence of taking the above Pills, which we have also used in 

our families, and have found them invaluable. 

James R. Mean, James Moore, 

Daniel S. Betts, Hannah Hitchcock, 

John H. Reynolds, James Mead, 

Abel Palmer, Thomas Bertram, 

Rev. R. Palmer, Isaac Olmsted, 

John R. Palmer, P. V. T. Jessup, 

Henry Bewsley, Stephen Waring, 

Samuel Jessup, Augustus Lyon, 

John Limpry. 
Mrs. Mary Blanchard, 206 Clermont Avenue, Brooklyn, was cured of 

Asthma of long standing by 

brandreth's pills. 

She is acquainted with other cases of persons cured of Asthma by the same 
remedy, and kindly permits reference. 



Painters' Colic Cured. 

Dr. Brandreth, 

Sir : — I am a painter by trade, and have frequently been troubled with 
slight attacks of colic, arising from contact with lead in the forms it is used in 
my business. My eyes have also been made somewhat weak from the same 
cause. Your pills have been my only medicine, and they have never failed to 
restore my health. For all the diseases incident to a painter, I think Bran- 
dreth's Pills a certain remedy. My journeymen, by my advice, always take 
them whenever their arms become paralyzed, or their bowels constipated, and 
they have been cured by a few doses. Painters will find your pills invaluable. 

Yours, &c., DENNIS NORTON. 

Sing Sing, March 23, 1865. 



Saint Vitus' Dance Cured, of Twenty-five Years' Standing, with Brand- 
reth's Vegetable Universal Pills. 

Sir : With the most grateful feelings and the highest consideration for you, 
I sit down to state one of the most remarkable cures perhaps you have ever 
received, and effected, sir, entirely with your never-to-be sufficiently praised 
Vegetable Universal, and, I might add, life-restoring Pills. 

The gratitude I feel makes me scarcely able to state the case, which would 
not, I am sure, be believed, were it not universally known in the town of Ware- 
ham, where we reside, and the miserable condition my dear wife, Lucy Hooker, 
has been in for the last twenty-five years, now restored to health and to her 
family, when for so many years she was considered to be beyond all human 
aid. 

For the last twenty-five years my wife has suffered from Saint Vitus' Dance, 
and a complication of diseases which the doctors only seemed to continue to 
make worse instead of better. Calomel and bleeding, tonics and blisters, then 
calomel and bleeding, tonics and blisters again. Every doctor round the coun- 
try at all famed was tried, until finally, she receiving no benefit, I thought I 
would try the mineral doctors no more, and therefore took her to Boston to 
Dr. Thomson. She went through several courses of his treatment, and ap- 
peared to gain some thereby. But alas ! she soon became as sick as ever. I 

13 



194 CURES BY PURGATION, 

then was obliged, she becoming suddenly worse, to send for two of the Ware- 
ham doctors again. They told me candidly she was beyond the powers of 
medicine, and that she must soon sink under her diseases. What was I to do "? 
I had often been recommended your pills, but always lield them in contempt. 
One medicine and one disease I could not understand. I told your agent, 
Abishia Barrows, of VVareham, what the doctors said. Again he strongly 
recommended the pills. 1 talked to my wife about them ; she said she would 
try, if there was any hope — hoped they might be blessed to her, but that she 
was resigned. I went for a box, and when 1 returned one of her doctors was in 
the room. He made a deal to do about it, said she could not bear them, they 
were too strong for her, she could not bear any kind of physic, that she would 
die in all probability from the effects of the first dose. The more he said in 
opposition the more Lucy was determined to try them, and actually took a dose 
of four pills in his presence, and while he was holding forth against them. Away 
went the doctor and reported through the town that I v/as killing my wife by 
giving her those Brandreth's Pills — those Prince of Quack's Pills — those Im- 
postor's Pills — and created quite an excitement. In the meantime she was 
receiving the benefit. 

The first dose of four had a most wonderful effect — no wonder at the state 
she was in. The corruption was indeed dreadful. She took six the next night, 
and the same results. Instead of their causing weakness, she became stronger, 
and able to sit up a little. She persevered, sometimes taking as many as twelve 
at night and seven in the morning. When her pains were severe she took 
larger doses, and she did the same if the appearance of the evacuations was bad 
— in fact we followed your printed directions most carefully. 

Sometimes she became worse — all the worst symptoms of the disorder pre- 
sented themselves. Often at such times have I trembled lest she should die ; 
but by persevering with the pills she soon recovered ; and after every attack of 
this kind she seemed to be more firmly established in the recovery of her 
health, or rather her health seemed stronger after each of these attacks.- At 
first, not only the doctors opposed her using the pills, but all her friends and 
relations ; they all considered that the pills would surely accelerate her death. 
But long since the tide of opinion has changed, and those who most opposed 
now most strongly recommend them. 

It is about sixteen months since she took the first dose. She has used in all 
one hundred and fifty-two boxes, all purchased of your agent in this place, Abi- 
shia Barrows. I consider that she is like one raised from the grave, to bless 
myself and family, and give your pills and a kind Providence all the praise. 
She has not enjoyed so good a state of health since she was a child, certainly 
not since we were married. 

The doctor who saw her take the first dose, I understand is entirely con- 
verted to your principles of curing diseases by continued purgation, and is try- 
ing to find out what your pills are made of But I believe he uses your pills 
in his practice — in fact I feel sure of it. 

The cures which have been made in our region since my wife's recovery are 
truly surprising. Every one that feels sick thinks of no other medicine than 
Dr. Brandreth's Pills. I hope, sir, you will come and favor our town by a 
visit ; you will find many .grateful hearts to welcome you. 

In the hope that you will live long to benefit mankind, I and my wife join in 
our mutual kind wishes and. grateful feelings, and remain. 

Very respectfully, 

WILLIAM HOOKER, 
LUCY HOOKER. 

Wareham, Barnstable Co., Mass., May 23, 1838. 




w 



CURES BY PURGATION. 195 

Yellow Fever Cured. 

A gentleman, with whom I am well acquainted, writes as follows : " In 
1838, at New Orleans, at the St. Charles Hotel, while at table taking dinner, 
before the soup was removed, I was taken with dizziness, dimness of sight, and 
confusion of ideas; in short, all the symptoms of yellow fever, though well five 
minutes before. I asked a waiter to lead me up to my room, for the confusion 
of mind and dizziness was so great, that I could never have found the way 
alone. When there, I took eight Brandreth's Vegetable Universal Pills, and 
laid down. I was watched carefully, and for three or four hours was partly 
delirious ; but in four hours the pills began to work, and my mind was clear 
enough to know my danger. Bleeding was recommended. ' Do you think,' 
said 1 to the doctor, ' I want depleting V ' Your life is not safe without it,' was 
the reply. ' Then I will take eight more Brandreth's Pills,' said I. Those on 
the top of the first eight, with plenty of Indian meal gruel, carried' me out of 
all danger, and half a dozen medium doses cured me entirely in less than a 
week. Those who want to be safe, should take a few doses of pills as a pre- 
ventive." 



Tenea, or Tapeworms, Entirely Eradicated with Brandreth's Pills. 

Reading, Fairfield County, Conn. 
Dr. Benjamin Brandreth : 

Bear Sir — I have been troubled with the tape worms for twelve years; 
many have come from me, from twenty to thirty feet long — more or less every 
day of shorter ones — every two or three weeks I had a sick time from them — 
pressure at stomach — heavy load — many have crawled from me while at work 
— injured my health so much that I was not able to work one half the time — 
spent a great deal of time and money in consulting physicians and taking their 
prescriptions — have been reduced very low by taking medicine, without effect 
— last fall heard of Brandreth's Pills as a Cure All — had but little faith in them, 
but was determined to try any, everything, I could find at all probable to cure, 
thinking that without some remedy I must be destroyed by them. I procured 
one box, took one dose, and one loorm came from me ten feet long ; took the 
second and third, which cleaned them all out, and I have not had one since. I 
have, however, taken several boxes of pills since, but have seen no appearance 
of worms. It is now ten months since, and I have gradually recovered my 
health, and ain now able to attend to my business as usual, and have no doubt 
that they are all extinct. When I was afflicted with worms, I wanted to con- 
sume three times as much food as I would if in good health. Now I take my 
regular meals, and am hearty and enjoying good health, and able. to do a good 
day's work. The last worm that came from me was twelve feet long. I have 
not the least doubt that it was Brandreth's Pills (your valuable Vegetable Med- 
icine) that effected the cure, as everything else that I could hear of was tried 
without effect. 

Yours very respectfully, and grateful servant, 

AARON T. DIMON. 

June 20, 1838. 

The above person is well known in Fairfield County. John B. Sanford, of 
Bridgeport, Conn., has assured me of his respectability. 



196 CURES BY PURGATION. 



Cure of Pimples on the Face of Three Years' Continuance. 

Dr. Brandreth : 

Dear Sir : For some considerable period I have been troubled with an 
impurity or acridity of the blood, which seemed to be past cure. My face, 
in consequence, presented an unseemly collection of pimples. I was abstemious, 
and seldom tasted any beverage stronger than water, and yet, with all my care 
as to diet, my blood, got no better, and my appearance continued the same. My 
face all the time seemed as if it was held near a fire ; it seemed as if something 
was on it that might be brushed off. It was very annoying, and caused me 
much anxiety, not because it interfered with my personal appearance, which it 
did, but because it more or less affected my health, which was beginning to 
break down. I took very little medicine ; but when the above state of things 
had remained about the same for three years, I was induced to use your pills. 
I took them, in all, about one month — every day, or nearly so — taking no higher 
dose than five pills, and sometimes only one. I think, altogether, I did not use 
over four boxes. They cured me completely. My face is free from all pim- 
ples and inflammation, and my complexion perfectly clear. Gratitude has in- 
duced me to render this account, which you may publish. 
I am, with respect, yours, &;c., 

N. H. BAKER. 

Sing Sma, March 30, 1855. 



The following modest note from Mr. Bemis, of Dudley, Mass., for a supply, 
tells its own story : 

Dudley, December 7, 1853. 
B. Brandreth : 

Dear Sir — I have sold all the Pills I had of yours, and the money is ready 
when you will send my receipt. Please to send more Pills as soon as you can 
• — send to Webster Station. I have sold $117 worth of your Pills, and they 
give universal satisfaction. 

Yours, with respect, 

PHINEAS BEMIS. 



Brandreth's Pills Never Failing in DiarrhcBa and Dysentery. Read. 

Battery Anderson, Sept. 9, 1864. 
Dr. Brandreth, New York : Please find one dollar enclosed, for which 
send me that worth of your Pills, as I have used and given all I had. These 
Pills have cured all who took them for the diarrhoea in a few days. Some had 
the disease two or three months. The army doctors had failed to cure in all 
of these cases. 

I have found your Pills to be never-failing in diarrhoea, bilious affections, 
headache, and costiveness. How is it the Sanitary people do not give out your 
Pills ? 

Yours, with great respect, 

PAUL P. DUFOUR, 
Co. A, Thirteenth Heavy Artillery^ Bermuda Hundred^ Vd, 



II 



CURES BY PURGATION. 197 

Captain Isaac Smith, of Sing Sing, says, thirty of Brandreth's Pills, taken 
according to directions, cured him of a very severe bronchial affection, after 
other means had failed, and he wishes his numerous friends to know the fact. 



Ilxtract from a letter dated Dawson, Iowa, April 24, 1866, to Dr. Brand- 
reth, from Andrew Logan, Esq. : 

" My wife became an invalid. Our physician represented her case as in- 
curable. I then called two other physicians, and the three held a consultation 
and pronounced her case consumption. I then discharged all the physicians 
and determined to trust to your Pills. I got five boxes, which she took accord- 
ing to the printed directions. By the time these were used up, there appeared 
a change in her condition for the better. I then bought fifteen boxes, and she 
continued to take them for three^ months, when her health was entirely re- 
stored." 

Original letter at 294 Canal Street. 



Pepsevepe in the Good Wopk. 

The Rev. Ezra Wilmarth, East Wilson, N. H., says : " He has seen the 
salutary effects of Brandreth's Pills in many cases, and is fully convinced of 
their great value ;" that he " thinks it his duty to recommend them wherever 
he knows there is sickness, and is confident that they are calculated to promote 
the general health of mankind." 



Nepvous Debility and Bilious Headache. 

Mr. Webber, whose case is mentioned below, is still living, a fine healthy 
man of over 67 years : 

William Wood Webber, of Grigg Street, Southsea, in the Borough of 
Portsmouth, England, bell-hanger, voluntarily cometh before me and maketh 
oath and saith, that he was for five years and upward dreadfully afflicted with a 
nervous debility of his whole system, attended with a bilious headache which 
prevented him (deponent) from attending to his business the greater part of 
that time. He (deponent) has sometimes been so violently affected as to fall 
down senseless, which had nigh once put an end to his existence. In this mel- 
ancholy state he was recommended to take Brandreth's Vegetable Universal 
Pills, and after taking them for four or five weeks, according to the directions, 
he was perfectly cured. It is necessary and essential to observe that after 
taking them six or eight times he was much worse ; but Dr. Brandreth informed 
him that such would be the symptoms, and prevailed upon him (deponent) to 
persevere, which he did ; he therefore went on, as above stated, and the most 
beneficial results followed. It is now six months since deponent was quite 
cured, and he has had no return of the said disorder, but keeps in the enjoyment 
of perfect health, which he entirely attributes to Brandreth's Pills, the Vegeta- 
ble Universal Medicine. 

WILLIAM WOOD WEBBER. 
Sworn at Portsea, in the said borough, this 15th ) 
day of December, 1831, before me, j 

^ D. Spicer, Mayor. 



198 CURES BY PURGATION. 

Indigestion and Disordered Liver. 

Brandrotli's Pills are warranted free from all mercury or other mineral. 
A gentleman writes : 

" I haye for years been afflicted with disordered liver and indigestion, and 
have been restored after years of suffering, merely by the use of some fifteen 
boxes of the Brandreth Pills. For several years I have been more dead than 
alive ; I have crawled about, for my locomotion could not be dignified by say- 
ing I walked. I had the best advice, but was blistered, bled, took blue pill and 
calomel until my mouth was sore, dieted, and drank mineral waters. At last 
I saw hope wiped out of my doctor's and relatives' looks — it was clear I was 
doomed. In fact this was to be expected ; for when I did get up in the morn- 
ing, I was more dead than alive ; 1 was unable to attend to any business, and 
exertion of any kind seemed too much for me to endure. In this sad state I 
read J. W. Webber's case, and also Mr. Cooke's, of Bennington ; these letters, 
with the advice of a friend, induced me to give the Brandreth Pills a trial. I 
began with only two pills, which purged gently ; in a few days I took two 
more, they also operated mildly : then I took four, feeling some apprehension 
about my bowels ; they operated finely, bringing away very slimy stools. I 
rested for a day or two, and then took two more ; then I took six, and at last 
I became fully convinced of the efficacy of purgation, as a cure for disease. I 
have taken as high as eight pills in twelve hours — but the dose must be in pro- 
portion to the sickness — inflammatory cases require strong doses, and all 
serious sickness where pain is present, the same. But with weak persons the 
plan is to begin easily, and sort of feel your way, taking larger doses as you 
proceed. . This method in the use of Brandreth's Pills has cured me, and re- 
stored to health one who had prepared himself for the grave." 



Letter from Arnold Buffum, 

THE PHILANTHROPIST. 

Cincinnati, Ohio, April 15, 1843. 
I)r. Brandreth : 

In the course of my life I have suffered often and much from sickness ; I 
think I have been under the care of physicians more than twenty different times, 
for weeks at a time. But for the last five years I have employed a physician 
but once, and then only for a single day ; not, however, because I have been 
exempt from frequent illness, but because I have found a far more speedy and 
effectual remedy in thy Pills, than I ever found in the medicines administered 
to me by my physicians. Wherever I go, I constantly carry a box of them with 
me, or at least a few of them wrapped in a paper in my vest pocket ; and 
whatever illness comes upon me, I invariably find relief from the use of 
them. 

Having been much occupied m travelling and public speaking, I have 
frequently taken severe cold, which before I used these pills, invariably resulted 
in soreness of the throat and chest, and a severe cough ; but latterly, though 
more exposed than ever, when I have taken a cold, by taking one or two pills 
at a time for two or three liights, I have invariably succeeded in removing all 
soreness of the throat and chest, and in effectually preventing the cold from set- 
tling on my lungs so as to produce a cough. 

Once during last winter, while travelling on horseback, and subject to 
much exposure, I was suddenly seized with a very sore throat, high fever, and 
entire prostration of strength and spirits, — by the use of two doses of the pills, 



CURES BY PURGATION. 199 

and drinking freely of cold water, a copious perspiration was kept up, and in 
forty-two hours one of the most severe attacks which I ever experienced gave 
way ; and in two days more I was able to pursue my journey. At another 
time, continual exposure and daily exercise in public speaking brought on a 
severe lameness in the small of the back and kidneys, which became so 
exceedingly painful that I was forced to speak sitting ; not being able to stand 
on my feet ; at length the soreness extended quite through me, and the pain 
became so severe that I never closed my eyes during a whole night, and 
several times during that night I had serious doubts whether I would live till 
morning. I. took seven pills, which went to the seat of the disease, and as by 
magic, seemed to lay hold of it, and carried it all off, so that I attended a 
meeting on the same evening, and spoke without pain for more than two 
hours, and the pain has not returned since. I regard this as one of the most 
extraordinary cures that I have ever known, and I can truly say that, in a 
similar case, I would not exchange Brandreth's Pills for all the medicine of 
the drug store. I have used the Pills, and administered them to others on 
various other occasions, and, as far as I know, in no case without complete 
success. Especially have I found them altogether superior to any other 
medicine I have ever tried for colds, coughs, and soreness of the lungs. I 
consider that the maker of them especially serves the great cause of humanity, 
and I shall recommend them wherever I go. 

Thine respectfully, 

A. BUEFUM. 



In October 1843, Aaron Hamilton of Sing Sing, Westchester county, was 
taken suddenly sick in the night with great pain in his bowels and stomach. 
He took six Brandreth Pills, and in two hours took four more. In a little 
time he threw up two worms, and passed several downwards. He has enjoyed 
good health since. 



Dear Sir : 



St. Vitus' Dance and Scrofula Cured. 

Sing Sing, 3d January, 1843. 



It is with gratitude and esteem that I address you for the purpose of in- 
forming you of the beneficial effects which your Pills and External Remedy have 
had in restoring one of my sons to health, who had been sorely afflicted 
winter before last with St. Vitus' Dance, and for a period of ten months he 
was entirely helpless from the terrible disorder. He was also subject to the 
Scrofula in his neck. By the use of your Pills freely, and also applying the 
the External Remedy to the enlargements upon his neck, he has become en- 
tirely cured. He has been now well over a year ; and I trust, by the blessino- 
of Divine Providence, he will continue so. 

You are at perfect liberty to make what use you please with this commu- 
nication. I consider it a duty I owe to you to make it, and hope it may be the 
.means of extending the usefulness of your most excellent medicines. 

I remain yours, respectfully, 

H. M. REQUA. 
To Dr. Benjamin Brandreth, 

Spring Hill, Sing Sing. 



200 CUBES BY PURGATION. 

Indigestion and Bilious Affection Cured, 

Sing Sing, January 14, 1843. 
Dear Sir : 

Tliis will certify that I have used your Vegetable Universal Pills for in- 
digestion and bilious complaint which had almost proved fatal to me. I had 
been under what was supposed good medical treatment, and used various 
advertised remedies, but Mdthout any good effect. I then made trial of your 
celebrated pills, which gave me immediate relief, and soon effected a perfect 
cure. I have since used them in my family with the best effect. They are 
the best and easiest purgative we ever used. 

I am, respectfully, yours, 

NICHOLAS FOWLER. 
Dr. B. Brandreth, 

Spring Hill, Sing Sing. 



Sing Sing State Prison, Feb. 4, 1843. • 
Dr. Brandreth, 

Bear Sir : About four years since, I had a very severe attack of the piles. I 
tried almost every remedy, but without any good effect upon my painful disease. 
I thought I would try one box of your Vegetable Universal Pills. I done so ; 
and before I had taken all the pills it contained, I began to feel the good effects 
of them ; and by the time I had taken four boxes of pills, I was entirely cured, 
and have never since been troubled with the painful and truly unpleasant 
disease. I entirely attribute my cure to your valuable and inestimable 
pills. 

Very truly yours, 

R. LENT, 
Architect, Sing Sing State Prison. 



Sing Sing, Jan. 24th, 1843. 
Dr. B. Brandreth, 

Dear Sir : If you alone were concerned in the present statement, the greater 
inducement for making it would be removed, for of course no testimony can' 
strengthen you in your convictions in relation to the value and efficiency of 
your Pills, which have already proved such a blessing to the thousands who 
have used them ; but I have looked out upon this vast expanse of creation, en- 
circling in its arms, as it does, thousands bowed down with sufferings similar 
to my own, who would gladly hasten to the same source that restored my 
health, if they were persuaded that they would meet with the same happy 
result. Therefore, Sir, it is that those thousands may be convinced, and profit 
by their conviction, as I have done, that induces me to state before the world 
a period of suffering, such as few have, and I hope few ever will know, and 
the permanent relief I received from your Pills ; but how to begin, I hardly 
know, to describe those extreme tortures that seized upon my arms, shoulders, 
side and face, having about ten years since contracted a very severe cold, 
causing a very severe fit of sickness, attended with an affection of the Liver, as 
was supposed, which was the consequence of my taking a great quantity of 
medicine — and I must say, I have not seen a well day since, until I commenced 
taking Brandreth's Pills. For the last ten years I have been afflicted with 



CURES BY PURGATION. 201 



what is commonly called Salt Rheum and Erysipelas, at times covering and 
seeming determined to devour my whole body, and by making use of various 
means was enabled to check the disease from time to time, until early in June, 
1841, my disease assumed a very different appearance; and unpleasant as the 
task now is to me, I will, for the sake of spreading light and knowledge in the 
world, give a few of the particulars of my case : swelling and painful affections 
of the joints, tumors formed under the skin with burning lacerating pains, and 
finally coming out in horrible sores, covering nearly the whole of the right 
arm, and penetrating almost to the bone, and spreading to my face, covering 
nearly half including the nose, making for the time an entire wreck of that 
organ ; from thence to my shoulder and side, and my whole body and limbs 
swollen in the most frightful manner. Residing at this time in one of tlie 
western cities of New York State, I had recourse to most of the eminent Phy- 
sicians of that part of the country ; and the most that they could do was to 
pronounce the disease a scrofulous affection, which it seems they were not pre- 
pared to combat. A change of air and climate was recommended, and in travel- 
ing I became acquainted with a lady from Sing Sing. She advised the use of 
Brandreth's Pills — but supposing that they could be of no use to me, as I had 
tried so many things, I thought little more of them at that time ; but after having 
endured the most excruciating tortures, and incurring great expense, I was, 
thank God, about six months since, by reading one of Dr. B.'s advertisements, 
and what I had heard about them, induced to purchase a box of Brandreth's 
Pills. Jealous of the article, I resolved not to have my imagination at all 
busy, but nevertheless to give them a fair trial, which I did, by taking accord- 
ing to the directions accompanying each box, as far as my feeble state would 
admit, two or three boxes. Overjoyed at the discovery of an article which I 
well knew improved my health, used them secretly for a few weeks, but be- 
coming convinced that Brandreth's Pills would cure me, I made bold to declare 
it. 

Sir, are you alone concerned to know if? I think not, for I know that the 
medicine that possesses the power to cure me is capable of conferring the same 
blessings upon thousands of others suffering, p'erhaps dying ; therefore, these 
are all concerned to know that they can be cured. In fact, all are concerned in 
the discovery of anything that tends to promote the happiness of the human 
race, for we are social beings and cannot suffer alone. Persons may doubt this 
statement as I have doubted similar ones, but be assured it is but too true ; 
and in giving it, I have unsolicited, to you, sir, and the world, if you choose to 
publish it, discharged a duty which I felt incumbent upon me in making it known 
for the benefit of those who choose to believe it, as I believe that I have been 
cured of a scrofulous affection of the worst possible character and of long stand- 
ing, by the use of less than twenty boxes of Brandreth's Universal Vegetable 
Pills, at an expense of less than Five Dollars, instead of chasing phantoms at a 
greater advance in fees, without any good results ; and when I look into the 
past, upon these solitary days and sleepless nights, I thank a kind Providence 
that it is as well with me as it is, and I thank you, sir, that you are enabled by 
your scientific researches to minister to our infirmities. 

RACHEL TURRELL. 



Fits Cured. 

This may certify that my son, of five years old, was attacked with epileptic 
fits, in 1837, and continued to be troubled with them for more than one year. 
After every other remedy had failed I tried the Brandreth's Pills, which effected 
a cure in about six months, and he has not been troubled with them since. 

DAVID CHAFFEE. 

Grafton Street, August 2, 1843. 



202 CURES BY PURGATION. 



Mr. Wilson, of 135 Christie Street, for twelve years was afflicted with 
Chronic Rheumatism, and for the last three years was not able to walk ; has 
taken twelve boxes, the pain has entirely left his feet and knees, so that he is 
able to walk with comfort. 



Miss AY*****, a young lady residing in Hubert Street, had a severe pain in 
her knee, from which she suffered excruciating pains for upwards of three years, 
which confined her to bed almost all the time. Dr. Mott and several others of 
the faculty had bled, leeched, and blistered to no effect ; by taking Brand- 
reth's Pills she has perfectly recovered the use of her knee. Observations on 
tl\e above would be superfluous. 



Mr. G. Miller, of Harlaem, in September last, was dreadfully afflicted with 
Fever and Ague ; the attack generally came on him every day about 12 o'clock ; 
the disease had debilitated him in such a manner that his recovery was doubt- 
ful. A gentleman who has tested the goodness of Brandreth's Pills, in his own 
family, persuaded him to try the medicine. After the first box the Fever was 
perfectly cured, and by continuing taking the medicine for about six weeks, per- 
fect health was restored. 



Benj. Weeks, of Westchester, was violently afflicted with Dyspepsia; he 
could not take any food without the most unpleasant sensations in his chest, 
head, and bowels. His chest was so sore that the slightest pressure gave him 
pain ; his life was most miserable ; numerous were the medicines used ; and the 
skill of the first physicians tried in vain ; as a last recourse he took Brandreth's 
Universals, and in two months they effected a perfect cure. 



Worms. 



A young woman a short time since took these Pills for a violent pain in her 
side. After three doses she parted with a worm fourteen inches in length and 
one inch round ; she has since been perfectly well, and has kindly allowed Dr. 
B. to refer any one to her. 



Jt is a fact that there are good remedies, but it is very doubtful whether 
there are many good physicians. Extraordinary cures in which Brandreth's Pills 
have effected a perfect cure after the most eminent medical men had altogether 
failed : 

Mrs. Luther, of North Third Street, near Second Street, Williamsburg, for 
seventeen years was seriously afflicted with a violent pain in her left side, which 
often became very bad. The side was wearing to all appearance away, and just 
over the seat of the pain was a place you might have laid an egg in. Extreme 
<lebility and general bad feelings were the consequence ; she could do nothing 
for herself and family with pleasure ; no relief was experienced from an3'thing 
used until July last, when Brandreth's Universals were recommended, and im- 
mediate relief was experienced, and on the 31st of December she assured Dr. 
B. the Pills had perfectly restored her health, and that her side was become like 
unto the other. Mrs. L. stated many other particulars, which, were there space, 
would be mentioned. 



CURES BY PURGATION. 203 



Cure of Terrible Ulceration. 

Second House from Tenth Avenue, Twenty-eighth Street, ) 

New York, Nov. 2, 1842. ) 
Dear Sir : Last January I was taken suddenly with pain in my left side in 
the night, and my wife had to get up and steam it, but the pain got no better ; I 
then sent for Dr. Adams. He ordered a poultice of bread and yeast, and then a 
lump began to form about six inches from my arm-pit. Dr. Adams gave mc pills 
which did me no good, and the pain still became more severe. At this period 
Dr. Adams brought another doctor with him, but I still continued to get worse, 
and although several other physicians came to see me, yet I continued to grow 
worse and worse. Dr. Adams opened at one time the abscess which tirst com- 
menced under my arm, and which had extended to my hip-bone and thence to 
the small of my back, and from thence to my shoulder-blades. Being poor, I 
sent for the dispensary doctors, and they attended me, but I continued to get 
worse, and the ulcers were some of them, such as I could see, more than half an 
inch deep. The doctors, both dispensary and the others who visited mc, only a 
few days before you called upon me, told me it was ten thousand to one whether 
I recovered or not — that I might not live through the night. This was in the 
early part of February. I had not been out of bed since the beginning of Jan- 
uary. At this time, the latter part of February, my wife went to see you, and 
beg you to come and see me. You dressed my ulcers for me that night — it 
took a yard of linen to dress them once. You left me two boxes of pills, which 
I used as you directed me, and my wife dressed me with your Universal Salve, 
and rubbed the callous places with the Liniment. In two months I walked to 
your office in Broadway, from Twenty-eighth Street, corner of Tenth Avenue. 
I came after that, seven or eight times for you, to see how my back got on, and 
to receive your further advice. I went on getting better every day, and my 
ulcers one after another got well, until the latter part of July, when I went to 
work, being a sound man, with the exception of having nearly lost the sight of 
my right eye, during my sickness, which, however, gradually gets better and 
better from the use of your pills. I send you this letter that you may publish 
it ; and should any one wish to inquire any particulars of my extraordinary cure, 
they can see me where I live, which is the second house from the corner of 
Tenth Avenue, in Twenty-eighth Street. 

I remain, dear sir, 

Yours very respectfully, 

PATRICK BRALLEY. 
To Dr. Benj. Brandreth, 241 Broadway, New York. 



Edmeston, Otsego Co., Jan. 4, 1839. 
Dr. Brandreth : 

Dear Sir : I feel it a duty I owe to tne public, as well as yourself, to inform 
you of the. astonishing efficacy of your truly valuable pills. I was attacked 
about the 1st of November last with the prevailing bilious or typhus fever, 
violently. The pain in my head and back was most excruciating. I took first 
six of your pills, then eight, ten and twelve at a dose twice a day, yet found 
no relief. My wife then read your directions to me, after which I took 
seventeen, then twenty and twenty-two. I continued to take twenty morning 
and evening for four clays, when I found the disease yielding and the fever liter- 
ally broken up ; I then gradually diminished the quantities according to your 
directions. In two weeks I was out again.* 1 used no medicine but the pills. 

* Others who pursued the ordinary course were confined from six to twelve and fourteen 
weeks. 



r204 CURES BY PURGATION. 



There has since been a number of cases of the same fever in my neighborhood, 
where the patients have followed the same course. J, E. used no medicine 
except your pills, according to your directions in " violent diseases," with the 
same happy effect. I took fifteen boxes ; another twelve, and others ten and 
down to four. Some used drafts upon the feet. 

Yours truly, 

WATERMAN BURLINGHAM. 



Melbourne, Victoria, 1st June, 1858. 
Mr. Blandford, Agent for Brandreth's Pills, Melbourne : 

Dear Sir : Having had a severe attack of inflammatory rheumatism, by 
which I was confined to my bed for several days, during which time I suffered 
the most agonizing pains in my side, back and limbs, and was fearful that I 
should be confined to my bed for a long time, my husband brought me one of 
Dr. Brandreth's pamphlets ; after reading it carefully, I concluded that I would 
try the pills, which I used as directed. I have been using them three weeks, and 
I am happy to say that to Dr. Brandreth's Pills I owe my recovery to health 
and strength. I feel stronger and better than I have done for a long time, and 
I am convinced that the disease is eradicated from my system. 
If you deem this letter of any use, please publish it. 
I am, dear sir. 

Very respectfully yours, 

MANDY WAYMAN. 
Little Bay Street, Sandidge. 

Melbourne, 1st Aug., 1858, 
Mr. J. T. Blandford : 

Dear Sir : I am a mason by trade, and for some time past have felt almost 
unable to attend to my business. Three weeks ago, on my way home 
in the evening, 1 stepped into a water hole and got quite wet, from the effect of 
which 1 took a severe cold, my whole body became much swollen, my breath- 
ing became very difficult. I had sharp pains in my chest, and in fact when I 
called on you at your office I considered myself in very great danger. I bought 
two boxes of Dr. Brandreth's Pills, and took six pills in the office and six more 
on my return home. In about five or six hours I discharged several quarts of 
water, and felt greatly relieved. I have continued to take the pills, and am 
happy to say am quite well. I consider the Brandreth Pills the means of sav- 
ing my life. I have heard them called the Poor Man's Medicine of America, 
where they are so celebrated. I trust they will be known as such here. I will 
never be without Brandreth's Pills as long as I can obtain them. 

Please publish this letter. I am anxious that the people here snould know 
where to get a medicine that they can rely on. 

I remain, dear sir, 

Yours respectfully, - 

JOHN ELANNIGAN. 
Howard Street, North Melbourne. 



Park Street, South Yarra, Aug. 20th, 1858. 
Sir : This morning, having mislaid my spectacles when the morning's Age 
arrived, I took it up merely to endeavor to read the large type of the leading 
article, but judge my astonishment when I could, with facility, peruse the small- 
est type. This extraordinary fact I attribute to the use of Dr. Brandreth's 
Vegetable Universal Pills. Make any use you please of this communication. 

Yours very truly, 

JOHN HARRISON. 



CURES BY PURGATION. 205 

Letter of the Rev. Ezra Wilmarth, in favor of the Brandpeth Pills. 

East Wilton, N. H., July 27, 1836. 
Dr. Brandreth: 

My Dear Sir : Having recently become acquainted with your valuable 
pills, and seen their salutary effects in a great variety of cases, I take the liberty 
of addressing you, stating my conviction of their value. Although I have 
heretofore been unfavorable to nostrums, I am fully convinced of the value of 
yours. 

I am a minister of the Gospel, of the Baptist aenomination, in this town, and 
pastor of a church, and am well known ; therefore, I hope my recommendation 
of your Pills will be of some use in causing those who know me to make 
trial of them, as I feel confident they are calculated to promote the general 
health of mankind. 

Wishing you abundant success in your attempts to benefit the world, 
I am, with high respect, 

Your obedient servant, 

EZRA WILMARTH. 



Bilious Remitting Fever and Dysentery Cured. 

Paterson (New Jersey), Aug. 18th, 1836. 
Sir : I write this out of respect to you for your excellent Pills, for both I 
and my family think it a great blessing that we have met with them again in 
this country, because we knew them to be excellent and good ; when at Leeds, 
in England, there it was always said if any person was sick, get a box of Bran- 
dreth's Pills and they will cure you. 

Sir, I have been sick of a bilious and remitting fever, for which I got three 
boxes, and they have done me more good than all the physic ever I took in my 
life ; for before I took them I was almost gone with a liver complaint ; and now 
I am as well as ever 1 was in my life. In my family we have had three attacked 
with the dysentery ; they (the Pills) cured them in two days, so that we have 
all of us great occasion to praise Dr, Brandreth's Pills. 
I am, sir, yours very truly. 

And greatly obliged, 

RICHARD HAMPSHIRE. 



Asthma Cured, 

Mr. John Benist, of No. 69 Chapel Street, New York, was afflicted with a 
dreadful asthma for nine years, during which time he was unable to lie down in 
bed, and frequently was gasping for breath, expecting every coming hour would 
be his last. He applied to several of the first physicians in New York, none 
of whom gave him the least relief. At last, Brandreth's L^niversals were 
strongly recommended, and in the course of a short time he found great benefit, 
and by continuing the Pills, he is now quite well, and able to attend to his 
business ; indeed he is perfectly restored to health. 



206 CURES BY PURGATION. 



Dyspepsia Cured. 

Newlnirgh, N. Y., Feb. 14, 1836. Dr. Braiidreth— 5^> .• The many flatter- 
ing notices you have received from respectable individuals, of the success of 
your Vegetable Universal Pills, render it unnecessary for me individually to 
eulogize, or those who are ignorant of the specific to censure. Having had 
ocular demonstration as well as bodily, J cannot refrain from expressing and 
publicly acknowledging the signal result and fmal cure of that dreadful disease 
laiown as Dyspepsia ; hoping such persons as may be afflicted with the above 
disease, this notice may influence some to make the experiment. You are at 
liberty to refer them to me voluntarily on my part. 
I remain your friend, 

JOHN A. STEVENS. 



Rheumatism. 

A gentleman who had lost the use of his limbs with Inflammatory Rheu- 
matism, and was so miserably afflicted that he could not turn in bed without 
assistance — the pains were violent in all parts of his body, but especially in 
his breast, back, arms and feet. This person took no other medicine than 
Brandreth's Pills — for two weeks he took 12 pills per day, and often as many 
as 20, and in three weeks he was able to get out ; and now, having persevered 
with them so as to produce copious evacuations every day, is at this time per- 
fectly cured ; it is not two months since he was first taken ill. Now, Dr. 
Brandreth would ask, would this have been the case with your bled man ? with 
the maji to whom mercury has been administered "? No ! he would have been 
in bed months, and his convalescence would have been tedious. The above 
gentleman is highly respectable, and can be referred to. 



A Running Ulcer of Three Years entirely. removed with Eight Boxes of 

Brandreth's Pills. 

Edward Brown, son of Mr. James Brown, St. James Street, Kingston, 
Ulster County, for three years had a running ulcer in his hip, which obliged 
him to be carried about ; the doctors were in daily attendance, and the best 
advice was had from New York. All did not relieve the poor child, who was 
not expected to recover. Brandreth's Pills were commenced with four months 
ago, and a decided change was effected before the third box was finished, and 
now, having taken eight boxes, is quite well. 

A little boy, aged four years, swallowed a pin, and, as a matter of course, 
his parents were much alarmed. Plis father called on Dr. Brandreth, who 
recommended him to give the child five or six pills per day, and no bad con- 
sequence would arise. This advice was taken, and on the fourth day powerful 
evacuations having been kept up, the pin was discharged, and not in the least 
corroded. Reference will be given to the parents, who are highly respectable. 

Mrs. S., in East Broadway, has been afflicted for nearly eight years with a 
bad leg, which prevented her going about. The sore was larger than the palm 
of the hand — she had had recourse to various dDctors, who frequently healed it 
up, but in a few weeks was as bad as ever. Brandreth's Pills were recom- 
mended, and in a short time her leg was perfectly healed, and she is again able 
to walk with pleasure and comfort, and the leg has every appearance of being 
perfectly sound. Reference as to the above can be made to Mr. Aaron Swartz, 
grocer^ corner of Pike Street and East Broadwa-y. 



CURES BY PURGATION. 207 



Difficulty of Breathing Cured. 

Danbury, Conn., March 8, 1836. — Dr. Brandreth — Sir : Will you be good 
enough to send us some more of your Vegetable Universal Pills 1 there are 
many persons here taking them for every complaint, and all find relief I can 
say they are the best medicine I ever took, and I have tried almost everything, 
but found no relief until I took your Pills. My difficulty of breathing is greatly 
relieved, and I am getting well. Many are taking them here for the same com- 
plaint, and find them very good. 

Yours, respectfully, ELIZA MORRIS. 



Piles Cured. 

Messrs. Coggershall & Walters, of New Bedford, have forwarded me the 
following facts of that most painful and unpleasant disease, the Piles. The 
original letter can be seen at 187 Hudson Street. Mr. McFarlane, of New 
Bedford, has been laboring under that most dreadful disease, the Piles ; he has 
had them upwards of two years — has tried various things from different doc- 
tors, to no effect. Brandreth's Vegetable Universal Pills were had recourse to, 
and a complete cure is effected. He is now quite well. 



{^From the Louisville Enquirer?) 

Liver Complaint Cured. 

Newark, Dec. 25, 1886. 
Dr. B. Brandreth. 

Dear Sir : Having been afflicted for ten years with a most dreadful liver 
complaint and dropsy, and tried every remedy that could be thought of, I gave 
up all hope, went into the country, left my business, to die in peace ; but hear- 
ing of your invaluable medicine, I was induced to try it, not expecting to be 
any better. To my surprise, I had scarcely taken one box before I felt relief. 
I have since taken three boxes, and now I am well, by the blessing of God and 
the use of your medicine. If you think this will be any service to let suffering 
people know this fact, you are at liberty to publish the above. 

Yours, with kind respect, 

(Signed,) LEWIS TOMPKINSON. 



Dysentery and Deafness Cured, 

August 20th, 1835. 
Sir : Allow me to express my grateful feelings for the benefit I have expe- 
rienced in your Vegetable Universal Pills in the cure of Deafness, which I have 
been subject to nearly thirty years. I have frequently been under eminent 
aurists in London, who have invariably syringed me, and who have all said no 
other mode of treatment would be of service. The latter part of May I again 
lost my hearing, with continual unpleasant noises in my head. It was with 
difficulty I could hear any one speak ; knowing you were an English surgeon, I 



208 CURES BY PURGATION. 

applied to you to be syringed, thinking that was the only remedy ; you refused 
. to operate, but told me a box of your pills would have the desired effect, and I 
was induced to try them, especially when I found that many persons had been 
cured of the same complaint. I have taken two boxes, which cost me fifty 
cents, and am happy to say, am completely cured. The dose I took was two 
or three at night, and twice during the time I took five. They never incon- 
venienced me in the least, and were remarkably easy in their operation— I 
certainly can recommend them to any one laboring under the same unpleasant 
disease. 

Permit me likewise to say my eldest daughter, two weeks since, had a 
dreadful Diarrhoea or Dysentery on her, which in two or three days reduced 

ijj^her frame, and I thought would have sent her to the grave. I immediately 
applied to you to know if the Vegetable Universal Pills would have the same 
beneficial effect en her as they had on myself; you told me to persevere and 
they would m.ake a cure — I had confidence in them, and am happy to say, by 
her taking from four to eight pills every night, the dreadful disease left in about 
a week. She is now well, and getting up her strength very fast. She took no 
other medicine whatever ; shs continues occasionally one or two pills at night. 
My family had used the Hygeian Medicine for upwards of twelve months, and 
found they could not leave them off, as Costiveness and Piles were sure to fol- 
low. Thank God, your Pills leave no such enemies behind them. I have no 

) hesitation in saying, that your Vegetable Universal Pills are the safest and best 
medicine myself or family ever took. Make what use you think proper of 
this communication, and you are at liberty to refer any one to me, and I think 
I am only doing my duty in thanking you, through divine mer«y, for the benefit 
received. 

I am, sir, yours very truly, 

JAMES LANCE, 
250 Eighteenth Street, near Broadway. 



Certificate of Joseph Goulden^ who has known the above Pills forty years : 

/ hereby certify^ that J have known Brandreth's Vegetable Universal Pills 

for upwards of forty years ; they were used in my family connections, in the 

County of Dorset, England, since the year 1796, many of whom they cured of 

old standing complaints. 

JOSEPH GOULDEN. 
Bridgeport, Feb. 18, 1836, 



Disease of the Prostate Gland Cured. 

Henry Lathrop, of Edmonston, Otsego County, New York State, a respect- 
able farmer, was afflicted for more than a year with this most painful, and gen- 
erally incurable disease. Some of our highest medical men pronounced his 
case incurable, and advised him to settle his affairs, and patiently await the 
result, as it was not in the power of medicine to save him. Mr. Lathrop, 
before he went home, called upon me, and having stated his symptoms, I told 
him what his disease was, and in this I agreed with the doctors who had said he 
was incurable. But I also told him I felt confident that if he would persevere 
with my Pills they would cure him. Mr. Lathrop proved his confidence by 
purchasing six dozen boxes, which he took home with him, and in about three 
month§ he returned to me in New York City a cured man, having used the Pills 



CURES BY PURGATION. 209 

as I directed. In fact, he said he never was better in his life. This was in 
1835. Since that period Mr. Lathrop has administered the pills to upward of 
a thousand persons, all of whom, he assures me, have derived the most aston- 
ishing benefit from their use. 



New Bedford, Nov. 7, 1835. 
Dr. Brandreth — 

Sir : About eight weeks past I saw some of your Pills, and read one of 
your wrapping-papers, but thought it was, as thousands of such things are now- 
a-days, a mere speculative, money-catching thing — still I was advised to try 
them by persons who said they were most righteous Pills. I was, however, 
faithless of their value; bat my complaint grew so violent that I purchased two 
boxes, took them according to the directions, and found that they helped me 
much. My neighbors, knowing how long I had been afflicted, were anxious to 
know the result, and I informed them that I had received great benefit from the 
two boxes, which would induce me to purchase more. My wife for a long time 
had been in a poor state of health. She also took some, and found great ben- 
efit. And now, sir, excuse me while I detail some of my complaints, the main 
body of which seem as though the main springs of life were all fettered. 
DYSPEPSIA or INDIGESTION, Weakness of the Lungs, Nervousness, 
Rheumatism, SICK-HEADACHE, ASTHMA, GREAT LOSS OF APPE- 
TITE, LANGUOR, TREMOR, COSTIVENESS, etc., etc. Such have been 
my varied symptoms, but I must and will say, that I never took such medicine 
as your Pills, which seem to touch all parts of my complaints. I intend to 
persevere with them, and you may send me 500 boxes, which you must charge 
at the wholesale price. 

I am, sir, yours respectfully, 

SAMUEL S. ALBRO. 



Piles Cured. 

Messrs. Coggershall & Walters, of New Bedford, have forwarded me the 
following facts of that most painful and unpleasant disease, the Piles — the 
original letter can be seen at 187 Hudson Street. Mr. McFarlane, of New Bed- 
ford, has been laboring under that most dreadful disease, the Piles. He has had 
them upward of two years — has tried various things from different doctors to no 
effect. Brandreth's Vegetable Universal Pills were had recourse to, and a 
complete cure is effected — he is now quite well. 



Newburgh, N. Y., Nov. 4, 1835. 
Dr. Brandreth — 

Sir : I was induced some time since, by the persuasion of a friend, to try a 
box of your Pills. From the immediate relief and happy result I have re- 
ceived from the same, I cannot but recommend them to my friends, and par- 
ticularly to all invalids who may be afflicted with costiveness, not to despair 
until they have given your Vegetable Medicine a trial. 

Hoping you may be the means of making us poor creatures happy, and add 
to vour popularity and wealth, I remain your friend, 

J. W. SWIFT. 
You may refer, or make what use you please of this letter. — J. W. S, 
14 



210 CURES BY PURGATION. 

Extraordinary Cure of Rheumatism, Diarrhoea, and Affection of the Lungs. 

John Shaw, of Pembroket, Washington County, Maine, being duly swonij 
says that he was taken violently sick about six months since. The pains in his 
head, breast, back, left side, and instep beinj so bad that he was unable to help 
himself, and was taken into the Chelsea Hospital in the City of Boston. That 
after being in said hospital five weeks, Dr. Otis said he did not know what was 
the matter with him, and that he could do nothing for him, nor could he prescribe 
any medicine. That he, therefore, was conveyed from the Chelsea Hospital to 
the Sailor's Retreat on Staten Island. That he was there physicked with all 
sorts of medicine for a period of four months, suffering all the time the most 
heart-rending misery. That, besides the affection of his bones, he was troubled 
much with a disease of the lungs. Sometimes he would spit a quart of phlegm in 
the day. Besides this affection he had a bad diarrhoea, which had more or less 
attended him from the commencement of his sickness. That at times he dreaded 
a stool worse than he would have dreaded death. That he can compare the 
feeling to nothing save that of knives passing through his bowels. After suffer- 
ing worse than death at the Sailor's Retreat on Staten Island, the doctor told 
him that medicine was of no use to him — that he must try to stir about. At 
this time he was suffering the greatest misery. That his bones were so tender 
he could not bear the least pressure upon the elbow or upon the knee ; that his 
instep was most painful; that, as the doctor said he would give him no 
more medicine, he determined to procure some of Dr. Brandreth's Pills, which 
he did from 241 Broadway, New York. That he commenced with five pills, 
and sometimes increased the dose to eight. The first week's use so much ben- 
efited him that the doctor, not knowing what he was using, said, " Now, Shaw, 
you are looking like a man again. If you improve in this way you will soon 
be well." That he found every dose of the Brandreth Pills relieved him ; first, 
they cured him of the pain when at stool ; that they next cured the diarrhoea, 
and finally the pain in his bones. That the medicine seemed to add strength 
to him every day. He told the doctor yesterday, the 11th inst., that he felt 
himself well, and also that he owed his recovery to Brandreth's Pills, under 
Providence — that he had taken the medicine every day for nineteen days. 
That the doctor told him if he had known he had been taking that medicine, 
he should not have stayed another day in the house. He considers it his duty 
to make this public statement for the benefit of all similarly afflicted, that they 
may know where to find a medicine that will cure them. 

JOHN SHAW. 

John Shaw, being by me duly sworn this 12th day of April, 1842, did 
depose and say, that the foregoing statement is true. 

JOHN D. WHEELER, 

Commissioner of Deeds, 



Cure of Insanity. 

Newark, March 8, 1838. 
Respected Sir : I have long felt it resting on my mind as a duty, to com- 
municate by way of letter to you, sir, the great benefit I have received from 
using your invaluable Pills ; they have proved a great blessing to my health. 
For the last two years I have had my health renewed by taking them after 
other physicians had failed in their efforts to relieve me of a disease that was 
fast tending to dropsy, and bordering on to madness of mind — insomuch I was 
pronounced insane by most all who saw me. As I was incapable of having 



CURES BY PURGATION. 211 

any charge of my family for nearly one year, a number of times I made an 
effort to take my life, but was prevented from so doing by that ever-watchful 
Eye that never slumbers nor sleeps. I am a living monument of the free 
mercy of the Lord to all who were witnesses of the disordered state that I was 
in when your medicine was thrown within my reach, and faith was given me to 
believe that it would relieve. I commenced taking it every night, and the first 
change I perceived about me was on the night after taking three doses. I felt 
a singular sensation in my ear, and on rubbing it, something gave way, that 
proved to be hard congealed wax. I felt such a relief of distress from my 
head, that I knew not what it could mean for some time, for the sound of my 
own voice appeared like another, and all sounds seemed different to my hear- 
ing from what they had for years past ; and for two weeks following the quan- 
tity of wax that came from out my ears would to many be pronounced too 
incredible to be relied on, unless they had seen for themselves, and my blood 
began to circulate more freely through my system, by gradually taking the 
pills which before had nearly ceased to move through my veins, and it appeared 
to me that my life was at times departing from the body. I could find nothing 
that animated or cheered my mind ; any way life had become a burden to me, 
but as my confidence strengthened in persevering with the pills, I found my life 
daily returning, and invigorating both body and mind, to the unspeakable joy 
of my family and friends; and since they have proved such a blessing to me, I 
have felt it my duty to recommend them to all with whom I have intercourse. 
Standing myself as a witness of their virtue in producing health of body, which, 
beyond a shadow of doubt, will give clearness of mind and ideas, which can- 
not be clear if those organs where knowledge lies are obstructed by disease, 
which thousands of our fellow-creatures are suffering under, and are still made 
worse by the treatment of our most popular physicians of the present day, by 
taking blood, and giving many things that are daily undermining and ruining 
the constitution forever, from having that strength that is natural for us, if we 
pursue the right course to obtain it by simple remedies instead of those of 
another kind, which is so unnatural as bleeding. The argument you lay before 
the public, and the experience I have had for myself on this important subject 
wherein life is at stake, has thoroughly convinced me that bleeding is injurious, 
and can and ought to be dispensed with, as it has been ascertained to a certainty 
that other means have been discovered that have the desired effect in producing 
health without proving so pernicious to the constitution as those mentioned. 

I have been instrumental of convincing many to take them, but the most 
are bound by that strong cord of prejudice which will not so much as admit 
plain facts to be true, but endeavor to paint them in a different color from the 
original ones given ; but I am encouraged that the time is nigh at hand, that 
people are awaking from their slumbers, and seeking after truth in all things 
respecting this life, as well as the life to come. It is true that error abounds 
on all sides, but we know that truth is of divine origin, and will prevail in spite 
of all opposition that is thrown in its way by all who love not our Lord Jesus 
in sincerity of heart, and are making every effort to amass wealth by imposing 
on the public in various ways to deceive the unwary ; but let them beware and 
take heed to themselves, that the curse of the Lord is upon their riches if their 
eye is not single to His glory and the good of their fellow-men. It is love that 
has urged me to speak in so plain a manner to one who is an entire stranger to 
me, and I hope it may be received by you, sir, as coming from one whose mind 
has been freed from prejudice, knowing that the motive I have in view is the 
good of my fellow-beings, whose welfare I feel deeply concerned in. Although 
moving in a very humble and obscure sphere of life, to which many are placed, 
may the Lord greatly bless and strengthen your efforts in the cause that you 
are engaged in, is the prayer of my heart. 

You are at liberty to make use of these lines as you thmk best. 

MARGARET E. A. SHATLAND. 
Dr. Brandreth, New York. 



212 CURES BY PURGATION. 



St. Louis, November 28th, 183'7'. 

Gentlemen : I deem it a duty which I justly owe, not only to you, but to 
the whole community, to acknowledge the beneficial effects which have resulted 
to myself from the use of that highly serviceable medicine, Dr. Brandreth's 
Vegetable Universal Pills. 

About eight months since I was suddenly taken with the Dropsy in my feet, 
the surface of which was likewise covered with the Tetter. 

I had repeatedly taken the advice, and followed the prescriptions of several 
eminent physicians of St. Louis, but derived no benefit therefrom. 

I had also tried many experiments, and used every medicine that could be 
suggested, but without any visible abatement of the swelling, and they remained 
in this unnatural situation until my sufferings were alleviated by the aid of Dr. 
Brandreth's Pills. Shortly after 1 had commenced taking your medicine I dis- 
covered a visible alteration for the better ; the swelling gradually subsided, the 
Tetter entirely left, my bodily health daily improved, and my feet once more 
returned to their natural size. 

Two months have elapsed since my cure, and my feelings now warrant me 
in saying that through your instrumentality I have exchanged a painful disor- 
der for a good sound state of health. 

That suffering humanity may read, and benefit from this disclosure, 
I beg to subscribe myself, yours gratefully, 

MARGARET BROWN, 

St. Charles Street, St. Louis. 

To Messrs. Tousey &: Michael, St. Louis^ Mo. 



Carrolton, Greene County, 111., Oct. 5, 1837. 

Gentlemen : I beg leave to inform you that my sister was taken about three 
weeks since with a violent intermittent fever ; at my request she took two of 
Dr. Brandreth's Pills, which did not affect' her otherwise than by creating a 
faint sickness at the stomach. The next day she increased the dose, which 
operated powerfully. She took the third and fourth doses, after which she had 
no return of the fever, her strength increased rapidly, and her health has been 
good since. 

A sister of my wife had been in a decline for several months with strong 
symptoms of a confirmed consumption. She commenced taking Dr. Brand- 
reth's Pills, and before she had taken two small boxes in doses of three and 
four per day, a decided change for the better appeared. She still continues 
their use, and the glow of health is fast taking the place of her late consump- 
tive expression of countenance. She will persevere in their use from a positive 
conviction that her health will be perfectly re-established thereby. Other indi- 
vidual cases I could mention. Suffice it to say, that all who have used the PilU 
to my knowledge praise them. 

Very respectfully yours, 

M rp . r. a T • ' LUCIUS S. NORTON. 

Messrs. Tousey &; Co., St. Louis. 



New Orleans, 14th Jan., 1838. 
" He that is wise is wise for himself, and he that scoffeth (at Dr. Brand' 
reth's Pills) alone must bear it." — Listen, oh, ye incredulous ! hearken unto 
the voice of your friend, and neglect not the counsels of those who have learned 
wisdom from experience. Know, you that are slow of heart to believe, that I 
am a man who has suffered many afflictions from a hereditary diseased system* 



CURES BY PURGATION. ^13 

From my youth up I have never known what it was to enjoy a moment of 
HEALTH, till lately. My disease has been a chronic headache and a severe de- 
bilitating weakness and faintness at the pit of the stomach, which diseases have 
been in a great measure removed by taking only TWO BOXES of Dr. 
Brandreth's Pills. I can now say, and with truth too, that I know what health 
is by experience ; and I would that I could raise my voice so high that all the 
earth might hear. Then would I proclaim the virtues of this invaluable medi- 
cine. But what is my aim in all this 1 Is it that I am interested in the sale of 
Dr. B.'s Pills ? Most assuredly, no ; I am in no way connected with their 
rise or downfall ; but I recommend them for the benefit of mankind, and 
especially to those who are to receive the most benefit from their use, my fellow- 
citizens of the South. 

S. FRIEND. 



Grand Gulf, March 6, 1838. 
Mr. Joseph B. Brockwat, 

Bea?' Sir : We wish you to send us some more of Dr. Brandreth's Pills, 
for we are entirely out. Since the people have found out we keep them they 
are called for every day. Send them by the first opportunity, and 

Oblige yours, &c., 

WHITEMAN & McFARREN, 



Warrenton, Miss., March 1, 1838: 
Mr. J. B. Brockwat, 

Agent for the sale of Brandreth''s Pills. 
Dear Sir : Enclosed we hand you ten dollars, the amount of the bill with 
which you furnished us some time since. The piUs we find very saleable, and 
the demand for them is very great ; in fact, so great is their reputed efficacy 
and virtue here, that we should feel ourselves in some degree guilty of crime, 
if we were to deprive them of so valuable a medicine. We wish you to send 
to us by some safe conveyance — by the captain or clerk of some boat in the 
trade — fifty dozen boxes Brandreth's Pills, and forward your bill to us on the 
usual terms. 

Very respectfully, your obedient servants, 

JOS. TEMPLETON &; CO. 



Port Gibson, Feb. 27, 1838. 
Mr. Joseph B. Brockway, • 

Dear Sir : Enclosed you have ten dollars in payment for fifty boxes of 
Brandreth's Pills, left with me some time since by your agent. 

For some length of time after receiving the agency, there was but little 
demand for the article, as people were afraid of some deception ; but since it 
has become known, the demand for it is rapidly increasing. I am now nearly 
destitute of the article, and as I have daily calls for it, wish you would send me 
a supply by Mr. O'Neilly — 20 doz. boxes would not be too large a quantity. 

Respectfully yours, 

D. Y. THOMAS. 



Mrs. Elwell's Case. 

MRS. EL WELL, then of Middlefield, Otsego Co., N. Y., was seriously 
attacked with inflammation of the stomach and bowels. She was given over 
by her physician, and a consultation of doctors was called. The decision was 
that she must die. She, however, partially recovered, but her stomach was in 



214 CURES BY PUliGATION. 

a very deranged state. Very little action could be produced on the bowels by 
the most skillful of the profession. She continued for many months under the 
treatment of one doctor after another, gradually growing worse, and so truly, 
deplorable was her situation for four months before she tried the Brandreth 
Pills, that nothing passed her bowels except by the aid of the most powerful 
cathartics. Sometimes eighteen of one kind of pills were given to her, then say a 
dozen of another, and a portion of some other medicine, before action could be 
produced, and then so great was her distress that, for the whole of the four 
months above alluded to, she invariably fainted when anything passed her 
bowels. In January, 1837, she thought she would try Brandreth's Pills, and 
sent to my office in Cooperstown for a box. She took four pills. On going to 
bed, her husband enquired as to the effect of her new medicine. She replied, 
" that she did not feel any effect at all." He then said, that in the morning, if 
she took a dozen more, he guessed they would operate like all the rest of her 
medicine. She answered, she did not know but it would, for she did not expect 
anything would cure her. However, early in the morning her bowels were 
moved, and without pain or distress, and consequently without fainting, to the 
utter astonishment of Mr. Elwell, and the great joy of his wife. In the course 
of a few hours, they operated four times equally easy, and the consequence was 
she did not lie down through the day more than one hour. She had not for 
months been able to sit up one hour in a day. The next evening she took 
another dose of four pills with the same happy effects. On the third evening 
Mr. Elwell called on me and purchased a large supply of the pills, related the 
above facts, and said he never would be without the pills in his house if they 
could be obtained. It is now two years since the above facts occurred, and 
Mr. Elwell informs me that his wife soon recovered her health, that he has 
never had occasion to call in a doctor for her since, and that her health is now 
very good. 

ELISHA FOOTE. 
Cooperstown, Eeb. 22, 1839. 



Annual Report of IVIp. Sinclair Tousey, General Brandrethian Agent, 

Louisville, October 18, 1837. 
Dr. Brandreth : 

Dear Sir : It is now one year since I opened an office in this city for the ex- 
clusive sale of your Vegetable Universal Pills, the sale of which since that period 
has increased beyond my most sanguine expectations ; I have been compelled 
to establish an additional office in the city of St. Louis, Missouri, for the more 
convenient supplying of that section of country. I was induced to become your 
agent here in consequence of being convinced of the unrivalled health-producing 
qualities of your pills. My aunt they effectually cured of what is commonly 
called a Sick Headache, of about thirteen days' standing, which had often con- 
fined her to her bed for several weeks at a time. My mother they entirely 
cured of a violent pain in her side, with which she had been afflicted for several 
years ; myself they completely cured of habitual costiveness. These, together 
with numerous other cases that came under my observation while at New York, 
convinced me of their efficacy in every form and symptom of the only one 
disease, for I am a firm believer now in Brandrethianism. The pleasure I feel 
in making them known to my fellow-beings is more than I can well describe. 
I presume, sir, that you are aware that your Pills were not known to any extent 
anywhere to the West of the Alleghany Mountains previous to my introducing 
them in Louisville ; taking this into consideration, together with the fact that I 



CURES BY PURGATION. 215 

am located in a fortress of M. D.'s (there is a medical college here) it makes 
my success and their unprecedented sale appear truly surprising. 

It affords me great pleasure to state that in every town where I have intro- 
duced these valuable pills that they have generally been received favorably, and 
their sale and popularity have invariably increased beyond all precedence, until 
scarcely any other medicine is used or thought of. 

The thousands of cures that have been effected by their use, together with 
thousands of testimonials received in their favor, have not only gone beyond 
my expectations, but they have perfectly astonished the bigoted enemies of the 
Brandrethian theory, and has, I am very happy to inform you, caused many, 
very many, who were formerly its bitterest enemies, to become its most zealous 
advocates. More than thirty-seven hundred of the most respectable of our 
citizens have voluntarily come forward and testified to the virtues of your medi- 
cine from their own experience. 

It now becomes my duty (which I think a pleasure), as your general agent for 
this section of country, to transmit you testimonials of a few of the very nu- 
merous cures effected by the use of your pills which have come under my own 
observation, and had I the liberty to use the name of every individual who has 
testified to their extraordinary virtues, it would not only astonish the Regulars, 
but it would cause the foundations of Esculapian practice to quake with fear, 
besides fdling at least one large volume. This, however, is not at all necessary, 
as the fame of the medicine is now spreading with such unparalleled rapidity 
that ere long its happy influence will be universally appreciated throughout the 
civilized world, and the only question invalids will ask will be, " Where can I 
cret Dr. Brandreth's Genuine Pills ?" 



Case I.— BILIOUS FEVER. 

Louisville, November 16, 1837. 
Mr. S. Tousey — Sir : I feel it a duty which I owe, not only to you but to the 
public generally, to acknowledge the great benefit which I have derived from 
the use of the Pills for which you are agent. I was attacked about six weeks 
since with chills and fever, from which I recovered in about three weeks, when 
I was almost immediately attacked with a bilious fever, from which I had great 
doubts of ever recovering. Fortunately, I was induced by some of my' friends 
to give Brandreth's Pills a trial ; and I now find myself, after the free use of 
these Pills for a few days, perfectly restored in health and able to attend to my 
business as usual. After finding the happy effects of these Pills upon myself, 
I was induced to give them to one of my children — a girl eight years old — who 
had been ill for some time, apparently in a decline. It gives me pleasure to 
inform you that she is gradually getting better since we first used the Pills, and 
I hope in another week to apprise you of her complete recovery. 
I am, sir, very respectfully yours, 

FELIX WOOD, 



! Case II.— DISEASE OF THE LUNGS. 

Mr. Summers, City Pump Maker, has been afflicted with the above com- 
plaint for seven years ; he tried a great many medicines before commencing 
with Brandreth's Vegetable Universal Pills, but never derived any benefit com- 
pared to what he received from them. He strongly recommended them to all 
as the best family medicine he ever used. Mr. Summers is well known in 
Louisville. 



CURES BY PURGATION. 



Case III.— FEVER AND AGUE. 

Mr. H. Humphrey was violently attacked with the Fever and Ague, and 
after using but four boxes of the Pills he found himself perfectly cured and able 
to attend to his business right off. Such is the extraordinary efficacy of your 
Ileal th-restoring medicine, which makes friends of, and creates health in, all who 
use it. Long life to its maker. N. B. — Mr. H. resides in Third Street. 



Case IV.— ERUPTION OF THE SKIN. 

Mr. James Conklin was afflicted with an eruption of the skin, together with 
severe pains in all parts of his body. He used several highly recommended 
medicines previous to trying our Pills, but all to no purpose ; he has used only 
a few boxes of them, and is now entirely free from all eruptions, his skin being 
now perfectly cured, and his body is quite healthy in every respect — no pains, 
appetite good, sleeps well. As many as fifty or sixty cases of eruptions of the 
skin have occurred where your Pills have been used and cures effected in this 
city. 

Case V.— GENERAL DEBILITY. 

Mr. John Downing's wife has been troubled wiuu a general debility for a 
length of time ; she has tried a few boxes of Brandreth's Vegetable Universal 
Pills, and finds them of great benefit. She is encouraged to persevere with 
them, being convinced that they are the best medicine she ever tried — the 
opinion of all. 

Case VL— DYSPEPSIA. 

Mr. James Allen, residing in Clark Co., Indiana, has been afflicted with 
Dyspepsia for several years ; he has tried but three 25-cent boxes and is much 
better, his appetite being restored, and his chest is free from pain with which 
he was troubled so much. His digestive organs are become healthy — that is all, 
but that is everything. 

Mr. Stockton, the writer of the following letter, 's well known in this quar- 
ter of the country. 

Case VII.— CHILLS AND FEVER 

Mr. S. Tousey : I am compelled by an impulse of gratitude to acknowledge, 
not only to you, but to the public generally, the beneficial effects produced upon 
my son by the free use of Dr. Brandreth's Vegetable Universal Pills, for which 
you are agent. About six months since, my son, 15 years of age, was very 
suddenly attacked by that vile disease called Chills and Fever. He was occa- 
sionally so violently stricken with it, that I had given him up, and thought all 
medical aid was useless. I was prevailed upon by my friends and acquaint- 
ances to give Brandreth's Pills a trial, but it was a long time ere I was con- 
vinced of their efficacy ; I almost detested the idea, but my friends perse- 
veringly persuaded until I was compelled to yield, and I am happy to inform 
you that after the free use of these pills only thirteen days, he was thoroughly 
cured and restored to sound health, and I am now Dcrfectly convinced that they 
are the best medicine extant. 

Very respectfully yours, 

E. F. STOCKTON. 

Louisville, 20th September, 1837. 



CURES BY PURGATION. 217 



Case VIII.— SWELLED LIMBS. 

Mr. H h has been afflicted for about 5 years with swelled limbs, accom- 
panied by very violent pains in every part of his body ; he was unable to 
attend to any business or obtain any rest by night. These symptoms were pro- 
duced by an excessive use of calomel. He used several bottles of Swain's 
Panacea and other remedies, but to little or no effect. He commenced with 
your Pills a short time since, and a few days ago he informed me the swellings 
had subsided, and the pain entirely left him. The Pills, to use his own words, 
" made him feel like a new man." 

In addition to the above, I would state, I have known a great many other 
cases similar to the above, where Brandreth's Pills have been used with the 
same happy results, all of which go to prove the extraordinary power of your 
medicine in removing the most inveterate diseases from the system. • 

Case IX.— LIVER COMPLAINT. 

Morgan County, Kentucky, Aug. 19, 1837. 
Mr. L. Tousey, 

Sir : It becomes my duty to acknowledge to you, and through you to the 
public, the great benefit my wife has derived from the use of Brandreth's Vege- 
table Universal Pills. About three years since my wife was brought very low 
with an attack of the Liver Complaint. A physician was employed, and after 
prescribing some time to no effect, he gave us this consoling information, that 
he could do her no good, and he thought nothing else would. After continuing 
in this miserable state some months, I was induced, from an advertisement 
which I read in the Louisville Journal, to give her some of Brandreth's Pills, 
thinking they could do her no harm if they done her no good ; and it gives me 
pleasure to inform you that, contrary to our expectations (for we considered her 
beyond the reach of medicine), she began to recover, and is now quite well. 
Should you consider this of any service to you, you are at liberty to publish 
it. 

Respectfully yours^ &;c., 

T. SMITH. 

Case X.— INFLAMMATORY RHEUMATISM, LOSS OF APPETITE, &c. 

Mr. James Johnson, residing in Grant County, Indiana, suffered for about 
three years with Inflammatory Rheumatism ; at times his feet were so much 
swollen that he could not get on his shoes ; besides this he was troubled with 
costiveness, being sometimes three or four days without a passage. In addition 
to this he had scarcely any appetite ; he had advice and medicine from several 
physicians, but without any benefit, except for a short time. He expected he 
never would again be blessed with good health. After reading numerous testi- 
monials in favor of Brandreth's Pills, and hearing them very highly recom- 
mended by some of his neighbors who had used them, he was persuaded to give 
them a trial, and now, after having used them about five weeks, he finds him- 
self able to put his shoes on and walk about as he used to do. Besides this his 
appetite is perfectly restored, his bowels also being regular and healthy. He 
says that he has an excellent appetite, and thinks Dr. B. should have a monu- 
ment erected to his memory for discovering so good a medicine. 

The following letter, from the Rev. M. W. Sellers, will no doubt be read 
with interest. Mr. Sellers is well known to numbers of our citizens here : 



:>18 CURES BY PURGATION. 

Case XI. 

Mr. S. Tousey, 

Dear Sir : I send you the following account of my case, and hope it may 
be of service to you in prevailing upon other persons to give Dr. Brandreth's 
Pills a trial. In the fall of 1833 I was attacked with a severe pain in my 
breast, which continued to increase until a pain in my stomach and side took 
place, which brought me very low. I took different medicines to remove it, . 
but to no eifect. I then applied to Drs. Luster and Constant, of Louisville. 
They pronounced it a severe case of Dyspepsia and Liver Complaint. I com- 
menced using their medicines, and found great relief in my side and stomach. 
I was in hopes a cure was effected, but the pain in my breast still remained. 

They then tried external applications to great length, with no success ; and 
last winter the pain had become more violent. Mr. R. Barnett, of your city, 
informed me of Brandreth's Pills. I told him I had tried the Hygeian Pills 
without deriving any benefit ; he told me BRANDRETH'S PILLS were the 
BEST. I then applied to you, as you may recollect, for some of these pills. It 
appeared to me at the time that my strength was so fast declining that I could 
not live long without some relief I commenced using the Pills, and shortly 
afterwards I was attacked with the pleurisy ; and as bleeding had become such 
a habit I was persuaded to be bled, but mended slowly, and at length I was 
more violently attacked with the same complaint again. It seemed to me that 
I could not live long. However, I took eight of Brandreth's Pills, and in the 
course of a few hours I felt better. I then took twelve more, and have had no 
pain in my side since. This encouraged me to continue their use for the pain 
in my breast, and I mended very fast. In one month I gained ten pounds in 
weight. I enjoy good health at present, and feel myself perfectly restored. I 
can say that Brandreth's Pills were the first medicine that appeared to relieve 
the pain in my breast, and in any case of sickness I would rather use these val- 
uable pills than any other medicine that I know of By experience of said pills 
in my family, particularly in my own case, I know them to be good; My 
mother who lives with me, nearly seventy ye „ s of age, has been afflicted with 
a urinary complaint for about ten years, and by using these Pills during the last 
summer is now entirely well. I have known several cases of fever and ague, 
two or three cases of scarlet fever, and other diseases that the human family is 
daily subject to, cured by the use of these pills ; several of my neighbors are 
using them for the breast complaint, and all find relief. I have no doubt but 
a great many other cures would have been effected by perseverance with the 
pills, but there is one great difficulty they labor under — timid purchasers com- 
mence using them and take one or two small doses, just about enough to make 
them feel a little queer, and get frightened and then away to the doctor, who 
takes great care to cry down the pills, knowing it stands them in hand to do so. 

I reside in Lettersburgh, Clark County, Indiana ; I have been a resident of 
said county more than twenty years, eleven years of that time I have been a 
minister of the Gospel, of the Baptist denomination. I am aware of the great 
opposition these pills labor under ; but let me ask one question, viz. : What 
food is best suited to our nature and health % I think the answer is, the vege- 
table. Then do not let us be opposed to the vegetable kingdom for our 
medicine. 

M. W. SELLERS. 

October 22, 1837. 

Annexed I send you extracts from letters received from my agents, which 
make the proof in favor of your Vegetable Universal Pills almost over- 
whelming. 



CURES BY PURGATION. 219 

The following extract is from the Postmaster at Henderson, Kentucky, 
dated 

Henderson, October 14, 1837. 
The fame of Brandreth's Pills is on the increase here, and I am daily 
receiving assurances of their efficacy in every complaint — fever and ague of a 
most aggravated nature has been in almost every case speedily and effectually 
cured. Yours, &;c., &c., 

(Signed,) P. H. H. 

The following is from the Postmaster at Hutsonville, a small village in 
Illinois, dated August 16th, 1837 : 

As regards Brandreth's Pills, I believe they give universal satisfaction ; at 
all events, I cannot keep them on hand long — almost every person who has 
bought of them' recommend them to their friends and continue themselves to 
use them — the last lot you sent me of fifteen dozen boxes did not last sales of 
two weeks. I have sold upwards of ten dollars' worth in one day, at retail. 

The above speaks volumes in their praise. Another agent writes : They are 
deservedly becoming so popular that I shall be able to vend a great quantity 
of them. I could furnish you a valuable receipt of their efficacy from expe- 
rience in my own family. Not only this, but the whole neighborhood bear 
testimony of their beneficial effects. 

In conclusion, I send you the annexed letter from H. Foster, Esq., my 
agent at New Albany, five miles below Louisville : 

New Albany, November 23d, 1839. 
Case XII. 

Mr. S. TousEY : Your favor of 20th ult. was duly received as to the success 
of Dr. Brandreth's Pills ; I can state, in general terms, that I have sold about 
160 dozen boxes of these pills, and have made a great deal of inquiry of those 
that have used them, and find they have been very beneficial to this community. 
I can recommend them with the utmost confidence. I can here state that last 
fall, when I became an agent, my wife was in a very low state of health, and had 
a very distressing cough ; she was apparently on the eve of going into a con- 
sumption — the use of ten boxes of the pills entirely restored her, and she has 
never failed since that time, when indisposed, to receive benefit from a single 
dose. I am yours, &c., 

HUGH FOSTER. 

You will perceive by the above testimonials that your medicine is justly 
in high repute in this part of the country, as it must be everywhere where it 
is introduced. I could, as I stated above, had I time and space, extend the list 
of testimonials of its efficacy to several hundred pages. 

I would state that I have sold, during the year past, nearly eighty-five 
thousand boxes of your Vegetable Universal Pills, and have not the least doubt 
but I shall be able to dispose of more than double this quantity during the 
coming year, as those that have been sold have established a reputation for 
them that will last as long as the body of man is subject to indisposition. 

My office in Louisville is 99 Fourth Street, near Jefferson ; and in St. Louis 
at 56^ Market Street, near Third. 

Wishing you every success, I remain, sir. 

Respectfully yours, 

S. TOUSEY. 
To Dr. Benjamin Brandreth, New York. 



220 CURES BY PURGATION. 

Pleasantville, Mt. Pleasant, Westchester Co., June 10, 1859. 
Dr. B. Brandretii, 

My Dear S r: I have long been a friend of yours, because I verily believe 
your valuable pills saved my life. I have recommended them for nearly twenty 
years, and don't want any others in my store. In 1849 I took a heavy cold, 
and being much exposed for some days afterwards, it settled on my lungs. 
For three months I was terribly troubled with a hacking cough and profuse- 
night sweats, and reduced almost to a skeleton. I took various syrups and cor- 
dials, but found no relief. At last a friend, Jesse Baker, of Miles' Square, 
Westchester Co., said, " Hammond, why don't you try Brandreth's Pills, they 
may help you." I bought a box, and took some. They purged me freely — my 
last dejection being a thick,- viscid, yellow matter. I found myself greatly 
relieved at once, and within a week got entirely well. I recommend your pills 
to everybody, and they always do good. I shall always sell them, and I think 
they are the best medicine in the world for coughs, colds, consumption, and all 
kinds of sickness, for I know them by experience, having administered them to 
over one hundred cases of disease, and always cured. 

Yours truly, 

W. H. HAMMOND. 



Jaundice Cured. 

Mr. Benj. J. Stebbins, a highly respectable and well-known farmer of 
Pawlina, Dutchess County, N. Y., w^rites July 9th, 1859, that he was pros- 
trated with jaundice every spring and fall for years, in spite of all the efforts of 
physicians ; that he was cured by a few doses of Brandreth's Pills, and " has 
never suffered from the disease since." 



See prge 21 for testimonial from Supervisor Bissell, of Newcomb, as to 
cures of Fmall pox ; also, page 46, from sixty soldiers ; and page 151 as to 
cures of rheumatism. 

These testimonials are selected runningr through a period of nearly forty 
years, and to those who would learn have significance. 

B. BRANDRETH. 



ASIATIC CHOLERA: 

Purgatives the only Treatment with Hopes of Cure. 



OPINTON OF 

SIR THOMAS WATSON, M. D., F. R. S., 
Professor of Theory and Practice of Medicine in KINO''S COLLEGE, London, 



It is well known by the reading public that for forty years, Dr. Brandr^'th 
has recommended Brandreth's Pills for the cure of Asiatic cholera and all lax 
affections of the bowels, because they remove poisonous and offending matters 
safely from those important organs ; he being opposed to the use of opium and 
astringents on the principle that they dam up the disease in the body and lessen 
the chances of recovery. 

Dr. Brandreth, as early as 1834, says the Asiatic cholera is, in all cases, 
without exception, connected with a poisonously contaminated state of the blood 
or condition of the system, that will not maintain a healthy action of the heart 
and organs generally, causing a feeble circulation, shown by the pulse, which 
hardly beats over forty in a minute, which occasions stagnation in the blood 
vessels, and an accumulation in the vessels of the stomach, bowels, and liver, 
from which the evacuations are simply exudations. 

These symptoms arrest the secretions generally, but of the liver and kidneys 
in particu'ar, and constitute, in fact, the essence or essential attributes of the 
disease. He asks: What are the indications to be fulfilled, or the requirements 
of a rational treatment 1 

Restore excitement to the heart and secretive organs, by divesting the blood 
of its poisonous qualities through the organs of the stomach and bowels, thus 
cleansing the liver and the kidneys, and restoring the heart to its proper 
action. 

With this view he recommends 

Brandreth's Pills as the Remedy, 

as universal experience has testified they excite the liver and all the secretions; 
in fact, their stimulating operation is general upon the whole system — upon the 
heart as well as upon the most remote membrane. These pills, therefore, in 
his opinion, fulfill the purpose of a sure, because rational treatment. 

After forty years of effort against the established practice, it is indeed a 
great gratification to know that his principles of cure have received the indorse- 
ment of the greatest liaht in the medical world. Sir Thomas Watson, M.D., 
r.R.S., recommends Evacuation as the cure for cholera, and condemns the 
use of opium and astringents. 

So early as 1831, Dr. Brandreth advocated the same method of cure which 
was successfully carried out in London. The same practice was very successfully- 
enforced in New York with Brandreth's Pills in 1834 and 1835, and again in 1848 
and 1849. In June of this latter year the most undoubted evidence of their great 
curative qualities in Asiatic cholera was published editorially in the New York 
Sm, say June of that year. In 1853 and 1854, in 1865 and 1866, they were 

(221) 



2^2 ASIATIC CHOLERA. 

the reliance of hundreds of thousands of families, and have seldom failed to cure 
Asiatic cholera, perhaps never when used in season. In fact, all recovered .who 
took them early, while those living where the disease was raging never had it, 
who used them occasionally, though constantly exposed. 

Yet Brandreth's Pills are not pretended to be an absolute preventive of the 
disease; nevertheless, common sense will tell every one that if a drain be opened 
and left free from filth, when a sudden addition of impure matters run that way, 
it would not overflow and poison the whole town, like one in a less free condition. 
So those using Brandreth's Pills, during the presence of cholera, will be safer 
than those who carry in their systems a load of impure humors, on which the 
disease may settle, and which Brandreth's Pills would have removed without 
csiiising any weakness, but actually appearing rather to increase the customary 
vigor. This same principle of evacuation, of purging, of cleansing, is equally 
applicable to rheumatism, bilious, and all painful diseases whatsoever. It has 
been tested by " time," and has not been found wanting. In fact he has strong 
reason to believe that the same high authority above quoted will ere long give 
in his adherence to the curative method of treatment by means of purgatives. 

Asiatic Cholera. 

Sir Thomas Watson on its Diffusion, Pathology, and Treatment. 

A valuable addition to our scant knowledge of the origin, nature, and dis- 
seminating media of Asiatic cholera has been issued from the press. Sir 
Thomas Watson, Bart., M.D., F.R.S., setting a commendable example to the med- 
ical profession, has published a revised edition of his " Lectures on Medicine." 
How necessary for the guidance of the pathological students who sat at the 
feet of Sir Thomas Watson a revised edition of his lectures had become, may 
be gathered from the fact that when the former edition was published — prior, 
be it observed, to the great visitation of cholera in 1865-6 — the learned doctor 
told his pupils, " whenever a suspicion arose that cholera w^as present in the 
community, not to try, in cases of diarrhoea, to carry off the presumed offend- 
ing matter, but to quiet the irritation, and to stop the flux as soon as possible 
by astringents, aromatics, and opiates." Whereas now^ while still entertain- 
ing no doubt that the true indication of treatment is to " stop the flux as soon 
as possible," he believes this may be best effected " by carrying off the offend- 
ing matter." 

Sir Thomas prepares the minds of his readers for the changes some of his 
opinions have undergone by observing that the last great visitation of cholera 
was " more fertile of instruction on many interesting points relative to the 
disease than any of the three preceding epidemics." In one very important 
particular Sir Thomas's views remain unchanged. He always held, and 
imagines that few of the original doubters remain unconverted to the doctrine 
that epidemic cholera is catching. He contends that it results from a material 
poison which is portable, capable of being conveyed from place to place, and 
communicated from person to person, or from inanimate substances to which it 
clings, such as articles of furniture or clothing. That the morbific matter floats 
als(j in the air, and may be wafted about by its currents, is a general and well- 
founded belief. Dr. Bailey says that when it travels over great distances, it uses 
the vehicle of human intercourse; but that it maybe diffused over smaller space, 
as from one part of a town to another, or from a tainted port to a ship anchored 
to leeward, by the movements of the atmosphere. With this opinion Sir Thomas 
concurs, and he adduces in support of it the following facts : 

The long migrations of the disease are not made rapidly. Its rate of prog- 
ress never exceeds, and is often slower than that of modern traveling. Its 
primary appearance in an island or a kingdom is always at its outer boundary. 
In our own country^ for example, it first planted its foot in a seaport town ou 



ASIATIC CHOLERA. 223 

the east coast, over against the mainland where cholera was raging, and whence 
ships had very recently arrived. The same is true of its subsequent visitations. 
On the other hand, the crews of vessels sailing from healthy places remained 
free from the disease until they have entered an infected port, or held inter- 
course with an infected shore. 

Confirmation of these statements is given by Dr. Bryson, in his statistical 
report of the Royal Navy, published in 1868. He says : 

The medical records of the service have been searched in vain to discover 
an instance in which either cholera-morbus or yellow fever made its appearance 
amongst the ship's company unless one or more of the men or officers had pre- 
viously — within at most twenty-one days — been exposed in some house, ship, 
or locality where the infectious virus which emanates from persons ill of the one 
or the other of these diseases existed. The spontaneous origin of either malady 
far away from an infected locality is unknown in the naval service. 

This may be taken as conclusive, as it seems to be equally clear from the 
examples cited by Sir Thomas, that the atmosphere forms one of the vehicles 
of infection. For instance, the towns of San Roque and Gibraltar, five miles 
apart, were abruptly smitten by the plague, not only on the same day, but 
almost at the same moment. At a small town near Toulon the plague fell upon 
the place in the night, and thirty cases occurred simultaneously on the following 
day. A curious circumstance in connection with this impregnation of the atmos- 
phere with choleraic poison was recorded in the Dublin Morning Register 
respecting the first epidemic — that of 1832: 

In the demesne of the Marquis of Sligo, near Westport House, there is one 
of the largest rookeries in the west of Ireland. On the first or second day of 
the appearance of cholera in this place, I was astonished to observe that all 
the rooks had disappeared ; and for three weeks, during which the disease raged 
violently, these noisy tenants of the trees completely deserted their lofty habi- 
tations. In the meantime the revenue police found immense numbers of them 
lying dead upon the shore near Erris, about ten miles distant. Upon the 
decline of the malady ^vithin the last few days, several of the old birds have 
again appeared in the neighbourhood of the rookery ; but some of them seemed 
unable, from exhaustion, to reach their nests. The number of birds now in the 
rookery is not a sixth of what it was three months ago. 

During the outbreak at Constantinople, in 1865, a similar migration of birds 
took place. It was observed that all the sea-gulls which used to flit over the 
waters of the Bosphorus deserted the place, nor did they reappear till the dis- 
ease had departed, and the atmosphere had become pure once more. A striking 
proof that the air may be a vehicle of infection — that the poison may enter the 
lungs with the breath — is furnished by the fact that two pilots took the disease 
in consequence of having their open boat towed by a ten-fathom rope at a con- 
siderable distance astern of the steamship England, on board of which cholera 
was raging. They were never on board the vessel. Both of them had 
cholera, and one of them died of it. Both took the disease home and trans- 
mitted it to their familes, near Halifax, where the disease had been unknown 
for many years.* 

Notwithstanding these proofs that infection may enter the lungs of healthy 
bodies, it is still doubtful whether the disorder can become epidemic, except in 
certain conditions of the atmosphere. Mr. Gluisher has observed that each 
epidemic in London has been attended with a particular state of atmosphere, 
"characterized by a prevalent mist, thin in high places, dense in low." He 
goes on to enumerate other atniospheric characteristics observable during the 
prevalence of cholera : 

* A thin piece of muslin or a silk handkerchief tied over the mouth, would have prevented these pilots 
from taking the disease. 



224 ASIATIC CHOLERA. 

A dense torpid mist, and air charged with the many impuriti<;>6' arising from 
the exhahitions of the river and adjoining marshes ; a deficiency of electricity ; 
and (as shown in 1854) a total absence of ozone, most probably destroyed by 
the decomposition of the organic matter with which the air in these situations is 
stronoly charged. 

More horrible than the knowledge that cholera may come to us in the air 
we breathe is the conjecture, now reduced almost to a certainty, that we may 
eat and drink the poison and so obtain the disorder — that the discharges 

FROM THE ALIMENTARY CANAL ARE AT ONCE THE. MAIN OUTLET FOR THE POISON, 

AND THE CHIEF SOURCE OF INFECTION. Dr. Snow has showH how easily por- 
tions of the rice-watH" excretions may come to adhere to our food during its 
preparation or consumption ; and the disgusting fact has been made too certain 
by the unchallengeable disclosures of the microscope that the water supplied 
for domestic purposes by the London water companies habitually contained 
visible particles of human ordure. In all the visitations of cholerar the disease 
w^as least virulent where pure water' was obtainable. Mr. Simon reported 
that " the population drinking dirty water appeared to .have 'suffered three and 
a half times as much mortality as the population drinking other water;" and 
the sudden, rapid outbreak of the disorder in the east of London, in 186G, was 
distinctly traceable to the unfiltered and infected water supplied by the East 
London Water Company. 

With respect to the propagation of the disease, Mr. Simon uses this strong 
lanojuaoje : 

It cannot be too distinctly understood that the person who contracts cholera 
in this country is ipso facto demonstrated, with almost absolute certainty, to 
have been exposed to excremental pollution. Excrement-sodden earth, ex- 
crement-reeking air, excrement-tainted water — these are for us the causes of 
cholera. 

Mr. Simon hopes that " for a population to be poisoned by its own excre- 
ment will some day be deemed ignominious and intolerable ;" and he says that 
the local conditions of safety are, above all, these two : 

Eirst, that by appropriate structural works all the excremental produce of 
the population shall be so promptly and so thoroughly removed, that the inhab- 
ited place, in its air and soil, shall be absolutely without fsecal impurities ; and, 
second, that the water supply of the population shall be derived from such 
sources, and conveyed in such channels^ that its contamination by excrement is 
impossible. 

It is shocking to think it should be otherwise now. (But no man can receive 
the disease unless there be those matters in the system capable of receiving it. 
All do not have it. How many 1 May the number not be increased ] Cer- 
tainly by using Brand reth's Pills.) See page 5fc^9, Vol. 2, of Sir Thomas 
Watson's Lectures, 1870, London, Longmans, Green & Co. 

" Haifa tumbler of fresh cholera dejecta found its way into a vessel of drink- 
ing water, the mixture being exposed to the heat of the sun during the day. 
Early the following morning nineteen persons drank from this pitcher. (The 
water attracted no attention either by its taste or smell.) They all remained 
perfectly well during the day, ate, drank, went to bed, and slept as- usual. One 
next morning was seized with cholera. Two were attacked the second morn- 
ing. On the third day two more were attacked. The remaining fourteen 
remained in their usual health, and were altogether untouched by the disease." 
These fourteen had nothing in their bowels or "blood on which the disease could 
fix and germinate. And this is how Brandreth's Pills save you from the chol- 
era, for these fourteen persons used Brandreth's Pills as their regular medicine 
when sick. 



m 

ASIATIC CHOLERA, 225 

The poisok u*- the disease the cause of the thickening of the blood, not 

THE PURGING. ReAD THIS PART WITH GREAT ATTENTION. 

Our knowledge of the morbid anatomy of cholera has become more com- 
plete and more exact in consequence of the post-mortem inspections, in cases 
of death during collapse, made by Dr. Parkes, Dr. Johnson, Dr. Sutton, and 
others. It is acknowledged o;i all hands that the primary and sp:^cial danger in 
cholera lies in its n^iod of collapse. Now it was a v.Ty natural and plausible 
theory which attrilRed tliis state of collapse to a drain upon the blood by the 
prtjfuse and repeated fluxes from the stomach and bowels, whereby the blood, 
being robbed cf its more liquid ingredient^, and made thick like tar or treacle, 
became incapable of flowing freely, if .'it all, through its natural channels ; and 
thus the circulation coming ultimately to a stop, life stopped also. And the 
practice suggested, and put in force, as a direct corollary to tliis theory, was 
that of endeavoring to arrest the destructive flux by astringent drugs, and by 
opium, to sustain or urge on the lingering circulation, and to restore the spent 
sti'ength and the lost animal warmth by alcoholic and other stimulants. Upon 
similar grounds was advocated the dilution of the thickened blood by w^ater 
injected into the veins. It is affirmed, on the other hand, that the con- 
dition CALLED COLLAPSE IS NOT DUE TO THE EXCESSIVE DISCHARGES FROM THE 
BODY ; THAT THOSE DISCHARGES ARE REALLY ELIMINATIVE OF THE POISON OR OF 
THE PRODUCTS OF THE POISON WHICH CAUSED THE DISEASE, AND ARE TO BE 
PERMITTED OR EVEN ENCOURAGED RATHER THAN CHECKED ; AND, THEREFORE, 
THAT ASTRINGENTS AND OPIATES CAN DO NO GOOD, BUT ARE, ON THE CONTRARY, 
POSITIVELY HURTFUL. 

Sir Thomas combats the first-mentioned theory, and quotes Dr. Parkes to 
prove that the most hopeless cases arc those of collapse after very scanty dis- 
charges or with no discharges at all. Savs Dr. Parkes : 

It may confidently be asserted that there is no one who has seen much of 
cholera who does not know that, exclusive of the mildest forms of the disease^ 
a case with liiile vomiting or purging is more malignant and more rapidly fatal 
than one in which these are prominent symptoms. 

Castor Oil and Purgatives Recommended. 

Now as to treatment. Dr. Johnson, of Liverpool, also holds that " the 
phenomena of cholera result from the entrance of a peculiar poison into the 
blood, where it probably undergoes a rapid process of self-multiplication, and 
spoils certain of the blood constituents, which are then ej"Cted through the 
mucous membrane of the alimentary canal ; that the feelings of general op- 
pression and malaise sometimes experienced before the onset of the bowel 
symptoms are indicative of blood poisoning; that the copious discharges are 
expressive of the efforts of nature to throw off" a noxious material, and really 
form, therefore, a necessary part of the process of recovery ; and that if the 
pouring forth of the Vascular excretion be checked (as it can perhaps be by 
opium), the risk of fatal collapse is thereby increased. He declares that the 
results of his own practice, founded on these views, have amply justified them; 
and a considerable body of other evidence has now been furnished in support 
of the same plan. Sir T. Watson thinks it is plain that, if " elimination " be 
a condition of recovery, the method of elimination is nature's method, which 
art may help or hinder — help by the cleansing method, hinder by the astringent. 
It should be remembered that one dreadful symptom of cholera consists in very 
painful cramps of the larger muscles of the body, produced, it may be assumed, 
by the choleraic poison. Dr. Johnson supposes that the stoppage of the blood 
is caused by the -same poison acting upon the muscular fib:es of the minute 
pulmonary arteries. Ihe thickening of the blood is a consequence, and not a 
cause, of the arrested circulation and the collapse. The true explanation of 



S26 ASIATIC CHOLERA. 

the fact that mere diarrhoea, however profuse, does not thicken the blood, is 
probably, as Dr. Johnson suggests, that water is rapidly absorbed from the 
soft tissues, to take the place of that which escapes from the alimentary canal. 
Such is the theory which Sir Thomas Watson thinks a reasonable one. He says : 

" It is founded on a true analogy; it is consistent with the symptoms noticed 
during life, and with the conditions discovered after death. We may therefore 
legitimately regard it, until fairly refuted, as a sound as welljtea most ingenious 
and important theory. In truth, it derives stroing confiriSmon from the fact 
that it unlocks, like the right key, the whole of the pathological intricacies of 
the disease. Thus, the emptiness of the systemic arteries accounts for the ex- 
tinction of the pulse at the wrist, for the cadaverous sinking of the eye-balls 
and falling of the features, for the blueness and coldness of the skin, and for the 
absence of syncope. The circulation stops, not from debility of the heart, as in 
exhaustion, but in consequence of a direct mechanical impediment to the onward 
course of the blood. We can understand the importance of brandy against this 
condition ; and. how, on the other hand, bleeding may help, both by relaxing 
the spasm and by unloading the distended right heart, to restore the circulation.* 
In this explanation Dr. Johnson presses, plausibly enough, the singular effect of 
the injection of fluids into the veins of these patients. It appears that, to be 
most influential, the fluids must be hot ; and he concludes that they act not only 
by diluting the morbid blood, but chiefly relaxing, through their warmth, the 
spasm of the smaller arteries. The blood then flows on again, and the symptoms 
of collapse are for a time removed. Again, the husky whispering voice is 
owing not to muscular weakness, but to the small volume of the tidal air in the 
respiratory currents. As but little venous blood reaches the lung-tissue proper, 
there is but little demand for air to meet and decarbonize it. The respiration 
accordingly becomes shallow, and the vocal pipe, feebly blown through, refuses 
to speak. Under the temporary impulse of the warm injections, the voice regains 
its usual tone and note." 

It is evidently wrong to dam the choleraic poison and its products within the 
body. Even when those products have, in one sense, been separated from the 
system, they may produce highly noxious effects if they remain shut up in the 
stomach or bowels, there to ferment and decompose. Admitting, as we must, 
that a minute quantity of the morbid excretions swallowed with water may 
suffice to produce the disease, a large quantity retained, through Aveakness of the 
expulsive powers or otherwise, can scarcely be harmless. Rather may we 
expect that its expulsion will tend to liberate the patient from danger and dis- 
comfort; just as the opening of large abscesses, and the discharge of foul pus 
and imprisoned gases, are often seen to rescue, as if by magic, a sick man from 
apparently impending dissolution. 

Having arrived at these conclusions, Sir Thomas has not far to seek for con- 
firmation of the theory. Dr. McCloy and Dr. Robertson testify that — 

Of 375 cases of cholera admitted into the Liverpool Parish Infirmary in the 
last epidemic, 161 proved fatal — a gross mortality, under all the modes of treat- 
ment adopted, of 42.93 per cent. Of these cases, 91 were treated with astrin- 
gents and stimulants, camphor and iced water, applications of ice, and hypo- 
dermic (opiate) injections ; and the mortality per cent, of these cases was 71.42. 
Eighty-seven cases were treated with purgatives, and with a liberal use of food 
and alcohol ; and the mortality was 41.37 per cent. One hundred and ninety- 

* This advice as to brandy and bleeding is bad, and will do hurt if followed ; but worse than all will 
be the effect of the injection of fluids into the veins. When the disease is treated by purgatives, vegetable 
purgatives, by 

Brandreth's Pills, 

the collapse never occurs, everything arranges itself by nature's own efforts, she having been assisted by 
means of Brandreth's Pills, which never weaken. 



I 



i ''*Ji'-<;';"-4» 



ASIATIC CHOLERA. 227 

seven cases were treated with castor oil only, and the mortality was 30.45 per 
cent. Dr. Brandreth affirms that over 90 per cent, recover when treated with 
his pills. 

Now, if this theory and practice in respect of cholera be true and right, the 
practice ought to be right in respect of the associated diarrhoea also ; and so, 
indeed, it is. Those who have largely tried it, strongly affirm that it is right, 
inasmuch as it is eminently successful. Dr. Johnson avers that he has found it 
so. And the concurring testimony of Drs. McCloy and Robertson confirms 
the soundness of the theory and practice. Their experience of diarrhoea was 
very extensive. Several thousand cases came under their observation in 
various dispensaries in and near Liverpool. Many were of a most severe 
choleraic type. The treatment they adopted was generally evacuant in its nature." 

Had Brandreth's Pills been used in the place of castor oil, the mortality 
would not have been over ten, and probably less than five per cent. ; in fact, on 
persons of sound constitutions, not one per cent. 

Remarks upon Cholera, Fevers, Small Pox, &c., dec. 

I now take pleasure in placing before the public a word further in reference 
to this disease, and other maladies arising from poison in the blood, among 
which I place cholera, small-pox, scarlet fever, yellow fever, typhoid fever, fever 
and ague, and all fevers without exception, including rheumatical and diptherit- 
ical. The maladies arise in the human body from the absorption of a specific 
poison, which seems capable of multiplying itself according to the condition of 
health of the patient when stricken down. Common sense tells us how little 
water it needs at the commencement of a fire to put it out, and the same prin- 
ciple is applicable to the getting out poison from the human body. A little 
energetic medicine in the beginning will do wonders in ridding the body of the 
poison, which much may be unable to achieve when it has got under a full head- 
way. So when a thing hurts, remove it, and in a choleraic attack, without the 
loss of a moment's time. We know that thousands of persons are living whom 
Brandreth's Pills have cured of this terrible disease, and we have the highest 
medical authority for their use. Such authority, indeed, tells us that the state 
of collapse is not due to the excessive discharges in cholera, but to the poison, 
which prevents the formation of carbonic acid by the union with the oxygen of 
the blood ; heat is not generated, but the blood remains charged with carbon, 
paralyzing the action of the heart, causing the slow pulse so observable in this 
disease, the dark skin and ghastly expression of countenance so awful in collapse. 
Then apply yourselves to the removal of the poison — and Brandreth's Pills are 
the remedy, safe, energetic, and sure ; safe, because they only act upon what is 
contrary to health ; energetic, because they act according to urgency of symp- 
toms; sure, because they never fail to produce purgation if given while sufficient 
vitality remains. Wait not for advice, but swallow six or eight at once, and 
continue with more or less according to urgency of disease, being guided also by 
bill of directions which are around each box. When you have produced bilious 
stools, or the disease moderates, the patient is safe. But Brandreth's Pills will 
do better for you than many doctors, and as much as any can. The diet should 
be good chicken broth, or from fresh mutton or beef. My opinion is, that broth 
made fro tn sheep's head is the most appropriate of all in affections of the bowels. 
It should be simmering a long time ; until the meat leaves the bone. When 
the pills have operated very thoroughly, ten drops of spirits of camphor in a 
half a wine glass of water seems to soothe, and can do no harm. But no spirits 
or astringent medicines should be used, because they dam up the poison if any 
remains, which may occasion a relapse. 

This seems to be a very easy method of treatment, and though the cholera 
is a frightful malady, yet, treated with purgatives, is a simple affair, and usually 



228 ASIATIC CHOLERA. 

curable. But aro purgatives indeed a proper remedy? Let us see. The 
greater the amount of the intestinal discharges, the greater is the sum of poison 
removed, and the greater the chance of recovery ; while the most hopeless and 
la!al cases are lh«»se paticnis who have very scanty dischar-ges, or no discharges 
at j:ll. If the terrible collapse were owing to the drain upon ihe blood effected 
through the intestinal discharges, it would be prolonged, deepened, and rendered 
more pei'ilous by the continuance of those discharges. But patients recover 
from a state of collapse, Bran<lreth's Pills operating at the titne; even in cases 
"where they have not been used, and when the evacuations were allowed to go 
on without trying to stop them by opiates or astringents, the patients have re- 
covered from collapse. This fact and our experience proves that in using 
Brandreth's Pills we are really aiding and following 

Nature's own Plan of Cure. 

Poison in the body, the aim should be to get it out ; that done, the patient is 
safe. When Bi-andreth's Pills cannot be obtained, castor oil may be used ; but 
it must be fresh, fur rancid oil will make matters worse ; and remember, castor 
oil is veiy prostrating, while Brandreth's Pills have a tonic and strengthening 
efftct immediately the operation is through, and even measurably v\tideitis 
going on. Sometimes there is severe sickness of the stomach ; for this, very 
hot boneset lea, or hot water is good, and Allcock's Porous Plasters to the 
chest and all around the diaphragm. The great object is to get the pills down. 
It the patient cannot swallow pills, rub them to a powder and mix with 
molasses, and give four eveiy two hours until they evidently operate. This 
effected, you will have warmth on the surface, which was before chilled by the 
approach of death. 

Diet, abstinence, and water, wisely employed, will do a great deal, and 
sometimes restore health. But this is obtained under the direction of able and 
learned physicians, whom the poor cannot have because they cannot pay the 
price. Now, Brandreth's Pills will do as much, often more, when used accord- 
ing to the printed directions which are around each box, than the greatest doctors 
can do for you, I humbly believe them to be 

The Medicine of Providence. 

And all can have them for Twenty-five Cents a box, and which could not be 
prepared for a dollar by any druggist, if prepared in a small way. Never be 
without those pills in the house; it is having them leady when you are first 
seizc-d wit-i cholera, or dangerous sickness, and taking them at once, that saves 
trouble, and nips the disease in the bud. 

In Conclusion, I beg the patient to submit to no injection of warm water in 
the veins, which takes away every chance of recovery ; to no subcutaneous in- 
jection of morphia; to no bleedings, leeches, or blisters ; to take no calomel, 
opiates, or astringents. A bandage of flannel may be placed around the body ; 
two or three Allcock's Plastei'S are better yet. And I tell you it these direc- 
tions are followed which I have given above, ninety-five per cent, of those who 
are attacked with cholera will recover, and I believe a larger proportion. The 
great thing to be remembered is to always have 

Brandreth's Pills 

about you, so they may be used at once, before sickness of stomach or cramps 
come on. The poison absorbed into your body being the cause of cholera, the 
beginning to take it out is the beginning of the cure, so lose no time in having 
to send for the pills. 

The public servant, 

B. BRANDRETH. 
January, 1872. 



PKINCIPLES OF CURE 



Thoughts on the Structure, Wear and Renewal of the Human 

Frame. 



Life, existence, the power to feel, feeling : who but God the Father created 
it, who " Breathed into man the Breath of Life, and man became a living soul ?" 
The life is in the blood ; the blood is life. 

Experience and reason tell us the importance of pure blood ; no impure 
blood can carry the " life" our great Creator intended us to possess. We will 
try and compile some words upon the principle of gaining healthy and some 
words on the structure, wear and renewal of the human body. 

The mighty oak proceeds from a small acorn. Whence does it derive the 
nutrition which makes it grow ? From appropriate fluids contained, in its mother 
earth. Whence do the ostrich and fowls of the air and of the water come? 
Verily from an egg. All fluid but the shell. Here we see a few weeks of the 
needed warmth converts the yolk and white of the egg into an organized being 
hardly less wonderful in structure than that of man. 

The oak obtains direct growth from the earth, while man derives his growth 
from the blood of his mother, which, though all fluid, provides the babe with 
bones, flesh, hair and the horny nail. Physiology teaches that all parts of the 
body were originally fi om blood ; or that at least they were brought to the 
growing organs by means of that life-giving fluid. 

The most ordinary experience tells the thoughtful mind, that at each 
moment of life, in the animal body, a continued change of matter, more or less 
accelerated, is going on ; that a part of the body is transformed into unorganized 
matter, loses its condition of life, and must be again renewed. There is suf 
ficiently decisive ground for the opinion, that every motion, every mental affec- 
tion, i3 followed by changes in the chemical nature of the secreted fluids; that 
every thought, every sensation, is accompanied by a change in the composition 
of the substance of some part of the body. Wonders surround us on every 
side. The mighty power of steam, and the continuous speed of the electric cur- 
rent are now understood, but the formation of a crystal, of an octahedron, is 
not less incomprehensible than the production of a leaf or a muscular fibre; and 
the production of vermilion from mercury and sulphur is as much an enigma 
as the formation of an eye, or the hair or nail, or the reparation of a bone from 
the substance of the blood. We know exactly the mechanism of the eye, but 
neither anatomy or chemistry will ever explain how the rays of light act. on con- 
sciousness, so as to produce the power of seeing. • 

We must believe that God works through the laws of Nature by immediate 
intelligence producing results, marked by evidences of design. No laws with 
which man is in the least acquainted, can tell how atoms group themselves into 
the f )rm of eyes, ears, and limbs; becoming instruments of optics, of acoustics, 
and of locomotion, or organs of thought and emotion. And we also believe the 
light that has been given us on the subject of purgation, as tending to the cure 
of disease, has been derived from a source which we will now call Providence. 
We know the principle is true, and that its enforcement in a human body causes 
to be thrown out what is hurtful, often preserving and restoring to health, what 



230 PEINCIPLES OF CURE. 

otherwise would have become disorganized and dead. Thousands of men and 
women are to-day alive and well, who, but for this practice, would have been in 
their graves, or in an abject condition of disease. 

We know the milk of the mother gives nutrition and growth to the child. 
Physiology teaches that the milk is derived from the mother's blood. Won- 
deiful adaptation ! the food of the mother becomes changed into blood, which 
provides milk for the child's sustenance, growth, and for the hardening of its 
bones. 

The chemical components or equivalents of an egg, of milk and blood, are 
nearly the same. Every part of an organized being may therefore be said to 
be derived from blood or its equivalents. 

Waste and Repair. 

The body wears. Movement causes waste. The hardest steel wears away 
when used. So also the body wears away, but unlike the steel, it is renewed 
faster then it wears away in a child, which is the occasion of its growth. It is 
a great truth, we die daily ; but the food consumed also supplies us with new 
life daily. These are marvellous facts ; this decay and renewal are among the 
wonderful mysteries of the Almighty. 

"We know the hair and our nails grow. Mark your finger nail near the root. 
Day by day ib advances towards the end ; at length we pare the mark away. 
The whole nail has been renewed, the growth was supplied, the waste was 
repaired. The same waste, the same renewal occurs in the nose, and all other 
parts, though we cannot mark the change as in the finger nail. 

Where the Reparations Are. 

The substance which is to form the nail is in the blood ; as perfectly mixed 
as a grain of salt is dissolved in a glass of water. As the blood circulates in 
the smalt vessels at the root of the nail, this nail substance deposits and organizes 
itself, and replaces what is worn away. The hair is also renewed by materials 
from the blood deposited in the roots of the hair; so the bones; and so the 
fl sh; and so with all other tissues and parts of man's body. Each part receives 
its needed supply of new material. Thus the eye retains its fire, thus the tongue 
its power of utterance, the brain the power of thought. 

Analogy tells us even the brain, the organ of thought, wears, and is renewed 
by the blood, which circulates and renews all the parts of the body alike, 
whether it be brain, spinal cord, the eye, the bones, the flesh, the hair or the 
nail. 

The blood carries new material to repair the waste, and it reloads itself with 
worn-out parts which it discharges through the appropriate vents. When the 
new materials are greater than the waste, the child grows; or the man spreads. 
When the waste is exactly equal to the new material, the body remains of the 
same size and weight. These facts indicate that the substance of all the 
organs and parts of a liviiag body are present in the blood. It is therefore im- 
portant to our well-being that this life fluid should be free from imperfections. 

For if the blood does not contain all the needed ingredients, or if it should 
contain more, it cannot renew the different parts according to their require- 
ments. Deformed and ill-made people owe their infirmities to the blood of 
their parents ; pure blood can do no otherwise than make perfectly organized 
beings, thus we may estimate the value of certain means to make the blood 
perfect. 

Food provides for the support or existence, and supplies all the parts of 
which blood is made. 



PRINCIPLES OF CURE. 231 



SUBSTANCES WHICH CONTAIN AND SUPPLY NUTRITION ARE FOOD. 

Healthy food possesses substance, because the stomach cannot grind it well 
without it possesses this quality. Too fine food makes the stomach weak ; it 
cannot use its muscular power, and debility of the stomach follows. If we do 
not walk, our legs soon become weak. To be strong, organs need exercise. 
When food is digested, part makes blood; the refuse passes off by the bowels, 
the kidneys, and the skin. Our stomach, if properly supplied, continually pre- 
pares new blood, which renews all the organs, carrying vitality to the hair and 
nail as well as to the head, with its master-organ, the brain. Every part is each 
moment of our lives changing, the worn-out parts carried away, and new parts 
supplied, whether good or bad. Here we see the necessity of eating and drink- 
ing several times a day. We constantly wear and constantly repair. Such is 
the law of our being. 

WORN-OUT PARTS MUST BE EXPELLED. 

The worn-out parts must be expelled from the body daily, or the blood will 
become impure. We may comprehend this by an inquiry respecting new-born 
children. They have taken no food by the mouth, and yet when born their 
bowels and bladders are full. Whence did these secretions come ? They came 
evidently from the blood of the mother, which made their bodies. We also 
know that sick persons, who eat no food for days, have evacuations by the kid- 
neys and bowels. These parts are also the worn-out parts of the blood and 
body. 

The blood is in fact a messenger, capable of taking, when there is a supply, 
to every part of the body what it needs for renewal, and also carries back to 
the bowels, kidneys and skin, worn-out substance to be expelled from the body. 

We therefore must admit that every part of a human body is made from 
blood; and that it wastes and is repaired ; that food makes blood which is dis- 
tributed with singular intelligence to all the various organs. 

HOW IMPURE BLOOD GETS INTO THE CIRCULATION. 

The bowels may be costive ; in this case there is an absorption into the 
circulation of gases and gummy substances, which are a great cause of poison 
to the blood. Should the kidneys fail to do their work, another source of 
poison to the blood is developed. Again, should the perspiration be checked, 
matters flow back upon the blood which soon load it with impurities. Suppose 
only the feet, by cold, cannot perspire, and their fetid exhalations flow back 
upon the blood. If all these outlets — the skin, the kidneys, and the bowels — 
do their work even imperfectly only, for a short time, it is evident that the 
blood will be burdened with noxious matters, which must interfere seriously 
with the circulation, and soon clog up the smaller vessels, so that only a small 
amount of blood can pass. Soon the lungs, the intestines, the stomach and the 
brain, will soiyid an alarm. You will have pleurisy, inflammation of the bowels 
or severe cholic, violent headache or sick stomach, because the worn-out parts 
of the body, instead of being carried out by those avenues nature designed, are 
shut up, poisoning the blood, thus causing it to become impure. 

Other causes besides these produce impurity of the blood. The food may 
not be healthy ; digestion may be imperfect ; troubles, grief, anxiety miasmas 
from swamps or other exhalations; breathing close air in crowded rooms; 
staying in too hot rooms ; all these causes tend more or less to vitiate the 
blood. Grief, fear and anxiety, hurt hy making the blood to circulate slower, and 
soon produce a very serious injury to the composition of the blood, occasioning 
stubborn fevers, and various derangements of the body and mind. Some are 
born with a larger portion of corruptibility than others, who are consequently 



232 PRINCIPLES OF CURE. 

more exposed to be attacked by disease. These unfortunates seldom live to an 
advanced age, unless their constitution improves, which is often the case hj 
applying the proper remedy at the proper time. 

Synopsis of Proceeding. 

All the parts of the body proceed from, or are made from the blood. 

All the parts of the body waste or wear, and are renewed by blood made 
from the food. 

That the blood is a messenger that carries a load both ways : i. e., It carries 
new blood to supply new material, and brings back to the bowels, the kidneys 
and the skin, worn-out material, to be discharged out of the body. 

The retention of these worn-out materials are the source of impure blood, 
and therefore the source of disease. 

Worn-out parts must be removed by Nature or Art. 

If there be a daily addition of what is wanting, and a removal of the worn- 
out parts, present health may be preserved, and even lost restored. 

The most important avenue of the cleansing process of the blood is the 
skin. Vastly greater in weight of worn-out parts go off by this channel than 
by the bowels and kidneys combined. So, when the perspiration is checked — 
known by the coming on of some sudden pain, accompanied usually by a cold 
feeling which finally takes the form of a violent chill — now no time must be lost 
in restoring it, by placing the feet in hot water, and taking from six to eight of 

Brandreth's Pills, or two or three Sarsaparilia. 

* This simple plan will prevent the sad consequences which may otherwise 
occur, and which often terminate in affections of the lungs or bronchi, that no 
art or medicine perhaps may cure. 

Excessive labor or excitement or mental application sometimes is the 
occasion of sudden attacks of sickness. This is produced from too great a 
quantity of the worn-out parts of the body remaining ia the circulation, the 
returning blood being unable to carry them to the proper outlets for their re- 
moval from the body. 

Bad air breathed, infallibly corrupts the blood ; contagion, touching bodies 
infected by disease; and excesses of all kinds, whether of drinking, eating, 
labor, &;c., are a source of impurity of the blood, and more or less injurious, 
according to the greater or less strength of the constitution. 

Pure and Impure Humors. 

The humors are the various individual fluids of a living body. .In man they 
comprise four-fifths of the whole weight, or thereabouts. They may be divided 
into two kinds, the good and bad. The ground may be considered the pure 
blood ; the bad the impure blood. Erom these are made the bile, the lymph, 
mucous, slimy, and synovial fluids, which give smoothness and limberness to the 
joints, and suppleness to various organs. Pure blood makes all the fluids 
healthy and good ; impure blood makes, in time, all the fluids unhealthy and 
bad. That is, pure blood makes us well, bad makes us sick. 

The humors are soon corrupted from any cause which interferes with the 
regular habits of the body, for in them the germ of corruptibility resides. 

* See Dr. T. R. Hazard's letter of advice. 



PRINCITPLES OF CURE. 233 

But pain is the certain sign that the humors are getting depraved. You 
must not wait too long before the remedy is taken. We should never forget 
that when the principle of corruption obtains the control, life ceases ; for corrup- 
tion is the extinguisher of life. 

Mucous, Slimy, Synovial Secretions, 

Healthy mucus keeps and preserves the suppleness of the membrane or 
covering which lines the mouth, the stomach, the intestines, the interior of 
the bronchi, the ear, bladder, the uterus, and the lining of the veins and arteries. 
The synovial fluid lines the joints and acts as oil does to machinery. Slime, I 
think, has its offices, but they are more vague. These secretions are all derived 
from the blood, which are healthy when the blood is good, and depraved when 
it is impure. Thus in colds, coughs, bronchitis, whooping coughs, mucus 
becomes phlegm, and is very troublesome. The mucous discharge flows from 
the nose, ears, bladder. It is seen in catarrhs and in other diseases. Its source 
is abated when the blood is purified, and gives no further trouble. 

Bile. 

Bile is a secretion from the blood, and is a very important humor. It unites 
with and separates the dreggy excrementitious parts from the food (chyme) 
before it becomes chyle, which feeds the blood with new materials, new blood 
in fact. It acts much the same as white of eggs does in clearing syrup. Bile 
is secreted more in hot weather than in cold, and is usually more needed, 
because more fruits and vegetables are consumed, and it separates the refuse 
from the healthy parts. 

How Decline (otherwise a Consumption of the Lungs) Is produced. 

We have seen how good blood is the source of health. Now, when this 
element of life is imperfect, it cannot supply health ; the hair may fall off, the joints 
will be stiff ; the skin will become sallow or of a dirty tint ; the breath will be 
of bad flavor; the eye will be dull ; the change in the solid parts of the body 
will be seen — the flesh will be flabby, and the bones painful. Because bad 
vapors or undigested elements in the iDlood, are condensed upon the various 
organs, and serve to make them grow or repair their waste, it is plain that 
organs made with a greater or lesser proportion of such materials cannot be 
sound. If the bad condition of the blood continues but for a few days or 
weeks, the body will be out of sorts and debilij^ated. Should this state remain 
for a considerable time, the whole of the body will be renewed with imperfect 
blood, and the individual's health will have become prostrated. He will be 
said to be in a decline. No organ seems more affected than another, except 
the lungs — there is always a cough and mucus raised — the person is said to have 
bad health, — is in a decline. 

Sound health needs no other name : bad health has every degree, from a 
headache and costive bowels to a complete breaking up of the entire system. 
Bad health in some appears to be a decaying condition of the whole body, one 
organ or part being affected very much in the same sort of a way as another. 

Pure and Impure Blood. 

Pure blood may be compared to clear water; impure blood to muddy 
water. If you pass muddy water through muslin, you soil it ; continuing this 
process, you cover it with thick mud. 



234 PRINCIPLES OF CURE. 

The blood passes through all the tissues and organs of the body, even the 
bones, and something of a very similar nature takes place in regard to them 
that takes phice in regard to the muslin. If the blood is impure, more or less 
dirt is left behind it. 

Should an organ, or part of the body, be weaker than the rest, there a 

freater quantity of impure matter will settle, and go on rapidly increasing, 
[ere is the source of our humors, swellings, enlargement of glands, boils, 
running sores, catarrhs, lung affections, fevers, intermittent and otherwise. 

We know this must be so, for these diseases are cured by purgation with 
Brandreth's or the Sarsaparilla Pills or innocent purgatives, which take dirty 
humors out of the body, and if they were not there, they could not be removed ; 
being there, we know they were left there by the blood. In these cases, purga- 
tives have, in forty days, taken out of a human body 100 pounds of most impure 
matter ; we know they could not have been in the bowels; they were part of 
each individual texture and fibre of the whole frame. This man was perfectly 
restored to health, though supposed beyond all hope of recovery. 

We have seen sometimes in the blood a natural tendency to free itself 
from impurities by vomiting, by sweating, and by spontaneous purging. It is 
these hints improved upon, and a remedy made in accordance therewith, that 
usually results in producing a radical cure. 

Collections of Impurities. 

The presence of impurities is not always a source of pain. The aggregation 
of humors in a large tumor is often without pain. While sometimes great 
suffering is occasioned by an inconsiderable swelling ; the fact is that the pain 
is the consequence of two causes ; the biting acrimony of the humors, and the 
natural sensitiveness of the part upon which they settle. 

Nature may be Assisted, but slie Cures, and sometimes alone. 

We have said nature sometimes frees herself from the humors which trouble 
her, without any aid. A sickness now and then defies all the methods of relief, 
and yet subsides upon some few pimples breaking out about the corners of the 
mouth or elsewhere. This proves the necessity occasionally of local applications. 
We see also that persons of strong constitution, and young, suffer for days with 
pains in the limbs, loss of appetite and fever, who suddenly get better after a 
cholic followed by slimy, bilious stools. 

IMPORTANT MEDICAL FACT. 

The relief produced by these natural intestinal evacuations were the original 
line or guide to this practice of Purgation, which enforced with our purga- 
tives, or other appropriate medicines, is destined to be adopted by the entire 
civilized world, at no very distant day. 

Cures Effected by Expelling Humors. 

When nature cures, it is by some evacuation. There is always something 
to be seen. Either rash, pimples, slimy humors, or bilious discharge. There 
is always an appeal to the senses. 

All can Comprehend. 

Animals of the brutal race, whose habits we can note when they are sick, 
eat those herbs which open their bowels, by which means they become cured. 



PRINCIPLES OF CURE. 235 

From these facts and reasoning we are satisfied that Purgatives are the 
sheet-anchor of curatives, and we have no doubt their use dates before the flood. 
But we know that David said, " Purge me with hyssop, and I shall be clean ;" 
and St. Paul, " Purge out the old leaven, and ye shall be a new lump." It is 
true these are illustrations spiritual, but how could they have application unless 
confirmed by practical experience in the body of matter? 

The purgative method is capable of being comprehended by both learned 
and by the unlearned. It needs no study; it is founded upon common sense, 
and is applicable to all disease. While so easily understood, it is nevertheless 
of great value, because it teaches us how we may cure one's self when sick. 
Those who know a purgative cures by its purifying effect upon the blood, are 
more sure of health than those who put their faith in other methods without 
this purifying treatment. 

How a Good Purgative Acts. 

A good purgative penetrates the whole mass of the blood. During the 
time of penetrating, whether one hour or six, no effect whatever is felt. When 
the impregnation is perfect, the blood begins to deposit its bad parts in the ves- 
sels which lead to the bowels. In from one to four hours the effect of from four 
to eight pills will be over. The body usually feels relieved of a load, even after 
the first purgation. How then shall we feel after twenty ? We shall feel well, 
renewed, disenthralled ; our sensations will be those of our early youth ; every 
organ of the body will rejoice in itself, and because it has been thoroughly 
cleansed. 

A good purgative never expels any but the dirty parts of the body or of the 
blood. Good purgatives cleanse all organs to the capacity of their strength, as 
a piece of soap cleanses according to the weight and the dirt it has to remove. 

Importance of a Speedy Supply of Food after Purging. 

After purging, the blood must be supplied with new material. This should 
be done quick. If you take out, you must replace by good warm oatmeal or 
Indian meal gruel, and while the purgation is progressing, if possible. Then eat 
your breakfast as usual after a little nap. In two or three hours, it will be well 
if a half a pint or pint cf good plain soup or broth is taken, made from fresh 
meat. This helps the purgation, and fills up with sound fluids the place of the 
nasty ones evacuated. 

By using purgation in this way every day for several days together, and 
then resting for a few days, doing this alternately, the whole body can be 
renewed much sooner than in the ordinary course of nature. Some intelligent 
men have said in from two to four months. This is a short space for re-making 
the body. In from six to twelve months I have no doubt it can be soundly 
re-made, provided Brandreth's Pills, or Sarsaparilla Pills be the purgative. By 
purgation a larger portion of humors are expelled than would be without; if 
these humors are replaced with wholesome, easily digested food, it will make 
new bone, new nerve, new skin, new lungs, and, in fact, every fibre and sub- 
stance of the body will be altogether new and without blemish. 

Follow the Path Indicated by Nature. 

From what has been said in the preceding pages, " We know, and from 
what we see and feel, that our bodies are subject to get out of order, inducing 
pain, and tending to their destruction. In this disordered state we observe 
nature providing for the restoration of order, by producing some salutary evacu- 



236 PRINCIPLES OF CURE. 

ation of the poisonous matter. She brings on a crisis by stools, vomiting, 
sweat, urine, expectoration, &c., which often ends in the restoration of healthy 
actions. Now, experience has taught us, also, that there are certain substances, 
by which, applied to the living body internally or externally, we can at will 
produce the same evacuations, and thus do, in a short time, what nature would 
do but slowly, and do effectually, what perhaps she would not have strength to 
accomplit^h." When, then, we have seen a disease relieved by a certain natural 
evacuation, we may reasonably expect a cure of it by the use of such sub- 
stances as have been found by experience to produce the same kind of evacuation 
or movement. Thus fullness of the stomach is relieved by vomits, affections of 
the bowels by purgatives, colds by a spontaneous sweat. So, when we are sick, 
if the trouble is above the diaphragm — the line w^hich separates the chest from 
the bowels — we may take some boneset or bitter herb tea, or other tea without 
sugar or milk. Boneset is the best tea to take. If a vomit is needed, this pro- 
duces vomiting. The medicine that we advocate, however, is one which expe- 
rience cf many years has proved seldom fails to suit the case, wherever located, 
whether in the chest, the head, the bowels, or the limbs; and the great advan- 
tage is, that under no circumstances can it harm. The celebrated Dr. Lull, of 
St. Lawrence county, N. Y., who used the medicine for over thirty years in his 
practice, says: "The Brandreth's Pills reduce, lessen and expel the principle 
of disease; and in proportion as they effect this great object, they increase the 
principle of life. That being purely a vegetable compound, they invigorate, 
purify, and cleanse the blood, correct and regulate all the secretions, and, by 
purgation, discharge the whole mass of morbid matter from the body without 
reducing the strength. If one hundred of the most enlightened physicians were 
to unite their individual skill, it could scarcely do so much to cure as a dose or 
repeated doses of Brandreth's Pills." 

In a book of " Authorities," comprising the opinions of upwards of two hun- 
dred physicians, published by B. Brandreth, M.D., in 1867, Dr. Hazard, of 
Newport, R. I., says : ''It is now nearly thirty years since I entirely abandoned 
the use of calomel, for which I substituted Brandreth's Pills, which I have found, 
after long and varied experience, produce all the good effects of mercury with 
none of its bad. One or two boxes of those pills will generally keep a family 
of ordinary size in health for a year. Thus any man by a small expenditure 
may keep his own family in health for a year, with very little, if any, loss of 
time, and not a farthing's expense for medical aid. This, as a general rule, I 
pledge my word, I know to be true by actual practice and observation. These 
pills are as efficacious in cases of hurts, bruises, cuts, sores, &;c., as in other 
maladies. By immediately cleansing the blood, they remove all danger of lock- 
jaw, festering sores, or congestion of the blood at the wounded or ailing points. 
Not unfrequently, from the use of opium in some of its varied forms, or o'.her 
malpractice, the morbid matter seeks to escape through vents called fever sores, 
I have known instances of this kind wherein, after the patient had been in acute 
pain for weeks, a few doses of Brandreth's Pills have turned the current of 
morbid matter from the sores to the bowels, through which it has been passed 
off, and the patient healed almost at once. But I do not mean to be understood 
to say that this is the rule ; as when the system has been surcharged and weak- 
ened by poisonous and stupefying drugs, nature's vital forces cannot always be 
rallied by any treatment that 1 am acquainted with." 

Thousands of pages of testimony can be produced like the above, showing 
the claims which Brandreth's Pills possess upon the confidence of the public. 
Indeed, little short of miracles have been wrought by their use, in 
EVERT form of DISEASE. It is wcll kuowu uow in the United States and 
throughout South America that they are the safest and most reliable purgative 
known. We take a dose of these pills, which in a short time are absorbed by 



PRINCIPLES OF CURE. 2S7 

the blood, on which it acts much the same that white of egg does on syrup, sepa- 
rating the impure parts from the pure. Should there Le any unpleasant sensa- 
tion some hours after a dose, remember it is not the pills which occasion 
them, but the humors which are put in motion. So soon as the impurities have 
left the intestines, the unpleasant sensations stop. Therefore, we know it is the 
humors which occasioned the pain, and not the pills. One thing the patient 
may rely upon, that Brandreth's .Pills never expel any but unsound humors — 
humors which make us sick and which must be expelled. 

After a good purging, the blood must be purer than it was before ; but re- 
member you cannot continue to improve, unless you replace the matters re- 
moved by good food. You cannot starve and be benefited by purgation. When 
by a moderate meal the blood has been supplied by new material, then the im- 
provement in the general feeling will be decided. By continuing every twenty- 
four or every forty-eight hours this process, the whole mass of the blood will in 
time become entirely renewed, provided care is taken to replace the impurities 
removed by healthy food. Healthy food, in fact, is as important as the medicine. 
All the taking out in the world will not cure, unless you replace what is taken 
out by nutritious food. 

A Cure easy before Humors have settled. 

Health is soon restored by this course when the humors are simply floating 
along with the circulating naass of blood, which is the case in all recent attacks 
of painful affections of all kinds. But when the case is chronic, occasioned by 
congestions, deposits, tumors, ulcers, dropsy, &c., the cure will be more tedious, 
or by the use of morphine or veratria, or any other anodyne or poison which 
fastens the depraved humors in the blood, making them more difficult for pur- 
gation to detach, as is the case after fevers, &c., &c. After purgation, the blood 
passes through diseased parts and gets foul again by cleansing them from a 
further quantity of their impurities. If it was pure before entering a diseased 
organ, it will not be so on leaving it. So, after some days or weeks, as the 
case may be, we must begin purging again, by carrying off through the in- 
testines the corruption it has contracted in the diseased parts ; on passing 
through them again, it will remove another portion of the evil matters. Thus, 
if the purging is repeated at proper intervals, the whole of the evil matters will 
finally be passed off by the bowels. It is merely a question of time; the tumors, 
the congestions, the dropsies, will as surely disappear as water from a vessel if 
constantly bailed out. 

Fistulas, running sores, scrofulas, rheumatic and other constant pains, 

ARE A CONSEQUENCE OF A SETTLING OF THE HUMORS. By USING BrANDRETH's 

Pills, the blood becomes purer. As it contains less impurities, it deposits 

LESS upon the parts AFFECTED, AND THE INTENSITY OF THE DISEASE DIMINISHES. 
By CONTINUING THE PILLS, A TIME WILL COME WHEN ALL THE IMPURITIES ARE 
TAKEN OUT OF THE BLOOD, AND NO MORE DEPOSITS ARE MADE. ThEN THE DISEASE 
IS CURED. 

The same rule is applicable to discharges of all sorts, as fluor albus, running 
at the ears, catarrhs, diarrhoeas, dysenteries, etc. In these cases, the humors 
are in the blood, and it throws them out in any way it can. Brandreth's Pills, 
in these cases, always cure by perseverance. Of course, good, easily digested 
food is indispensable. 

Thus, we see by purging with Brandreth's Pills, the entire* fabric of the 
body can be entirely renewed, reconstructed, and renovated. The defective por- 
tions removed and remade from the food consumed. 

In very painful diseases, such as inflammatory rheumatism, and inflamma- 
tory affections geaeraliy, the wise course is to use the pills in such doses as will 



;^8 PRINCIPLES OF CURE. 

produce energetic purgation. Also, in cases of stubborn costiveness the same 
rule must be observed. 

Many persons have used these pills for supposed incurable diseases, and 
have continued to live on quite comfortably to what had been their lot before 
they used this great medicine. At length their constitutions underwent a 
change, and they recovered their health completely. The pills were taken once 
a week in some, two or three times a week in others; again, in some not 
oftener than twice a month with the same happy result. One thing is certain, 
that the body never gets used to Brandreth's Pills. After every dose the blood 
is freer from bad qualities than it was, and this is soon well understood and acts 
as a guide in their further use. 

Synopsis of Proceeding. 

Brandreth's Pills are digested, and their active purgative separating quality 
circulates with the blood, passing thus through every part of the body, which, 
thus stimulated, deposits its impurities in the organs communicating with the 
intestines. By continuing the process, the whole body becomes renovated and 
renewed, all its bad parts being purged away and new parts remade, which oc- 
cupy the places of the old unsound ones removed. 

Remarks General upon Blood-Vessels in Health and Disease : 

Food, Appetite ; Need of Restraint, and the Wisdom of General Modera- 
tion while USING- Purgatives; Excelsior Medical College — its Objects; 
Hopes of a sounder Medical Knowledge for the Public. 
When in health our veins and arteries are full of good blood, while persons 
whose bodies are diseased have often less good blood than foul humors. The 
more impure humors the less blood. The abundance of impurities are indeed often 
so great that hardly sufficient good blood remains to continue life. Here we see 
the evil principle of sickness nearly extinguishing the good principle of health. 
In these cases of feeble vitality we have to feel our way. Two Brandreth's 
Pills night and morning, with an occasional dose of four or six pills, will be 
sufficient as a commencement as a rule, being careful to supply the patient with 
nutritious food. Slops, as gruel and broths, in much quantity, are apt to turn 
sour with patients of this class. Beef tea and mutton chops, tenderloin beef- 
steak, and broiled chicken agree, and should be supplied. The usual food is 
often all that can be obtained; good roast or boiled mutton or beef, even if 
cold, should form part of the diet, is easy of digestion, and makes good blood. 
The more appropriate the food, and the more it is relished, the sooner a return 
to health may be expected. 

Excelsior MsiftCAL College. 
Before long I hope to see a certain corporation of the State of New York 
endow a hospital where the poor may come and use Brandreth's Pills under the 
direction of experienced nurses, and where the most appropriate variety of 
victuals and drink will be amply supplied, and all without any expected return 
but the blessing of the Bountiful. 

IVIilk. 

Milk toast may form part of the diet if it agrees with the patient, but milk is 
not deemed the most appropriate food while using the Brandreth Pills. And 
cold vegetables and cold water had better be abstained from while th.Q pills are 
in you^ as well as fruits generally, which are apt to lay heavy or turn sour. 
Some persons who have used Brandreth's Pills extensively say these things 
never hurt; perhaps not, but they do not give the medicine a fair chance. 



PRINCIPLES OF CURE. 239 

They certainly interfere, to some extent, with the intended action of the pur- 
gative effect, and call greatly upon the vital forces, beside running the risk of 
colics. I remember once being called to a man in the night suffering from gri- 
ping pains, which his family took for inflammation of the bowels. 1 found he had 
taken four Brandreth Pills before going to bed, for costiveness, and ate a large 
half-ripe apple at the same time. There was no help for it. I gave him ginger 
tea and six more pills. It was wind. In half an hour he got rid of the trouble, 
and in future will be careful to eat apples at a proper time and ripe or cooked. 

In using Brandreth's Pills or any purgative, the intention is to operate upon 
the bowels, to obviate costiveness, remove some fulness or settling of humors 
from the head, or other part. To effect this object you desire the full action of 
the medicine, which is a very important feature in purgation. Cold bathing and 
cold vegetables and fruits, or cold water, ore sure to retard the effect. You 
take a purgative to purge; cold applications, externally or internally applied 
to the body, have the tendency to measurably hinder this action, and, therefore, 
to use them at such a time is pulling the wrong way for your health. When 
you use Brandreth's Pills, if possible use warm comfortable diet. Whether of 
meats or drinks, these help the medicine and the cure. Ordinary diet and 
ordinary washing may be adopted with moderation. But because you may 
wash in cold water, even bathe, if that is your daily practice, you need not be 
dabbling in the water for an hour. If you do bathe, bathe quickly while using 
the pills, and what is of equal importance, dress quickly. Because a drink of 
cold water will not hurt you, you need not drink a quart without taking it away 
from your mouth. 

The proper plan is the day a purgation is taken, even one Brandreth's or one 
Sarsaparilla Pill, it is not well to eat any raw fruit, lettuce, cabbage, radish, 
even watercress is best abstained from. But if you do partake of these things, 
let it be in great moderation. 

THIRST A GOOD SIGN. 

Thirst is a good sign when Brandreth's Pills are used, and proves they are 
doing good. Suppose the patient can get nothing but water. Jn this case let 
him drink only a little at a time, so that the stomach shall not get chilled. But 
the patient must be in a poor case who cannot procure a piece of bread well 
toasted, and put hot into cold water. This is Toast Water. Now toast water 
is always proper when you are under the operation of Brandreth's Pills, and 
can usually be procured. Some people say plain water sours, but toast water 
never. Let such use toast water; it is simple and good. Use intelligent judg- 
ment, and neither your diet nor your habits need feel restraint while you are 
using Brandreth's Pills, which are all vegetable and innocent. 



Patients who have done the medicine most credit are those who understand 
its use best. In nearly all these cases it has been their own intelligence which 
has taught them. Both Brandreth's and the Sarsaparilla Pills are innocent, and 
warranted free from all poisonous ingredients whatever. A person of sense 
soon learns how to adapt the dose to his case and constitution. Also the best 
diet to quickly make new blood to supply the place of the bad humor removed. 



Synopsis of Proceeding. 

The more impoverished the blood, the weaker the patient ; therefore greater 
necessity for nutritious food. Broths, gruel, not so good for the weak as beef 
tea beefsteak, mutton chops, chicken, oysters, &;c. When good things can be 
got and relished, the road to health is straight ; when they cannot be obtained, 
or when obtained not relished, the road to health is very crooked. 



•240 PRINCIPLES OF CURE. 

Agitations, Low Spirits, Despondency. 

The approach of a radical change for the better in the condition of the blood 
preceded by want of appetite, despondency, flying pains, sometimes in the chest, 
between the shoulders, small of the back. 



In these cases we recommend an Allcock's Porous Plaster, to the chest, side, 
or back ; it seems to act locally very slightly on the skin, producing a tonic 
effect, but inflillibly does good and helps the restoration to health ; sometimes 
the want of appetite is referable to a peculiar agitation of the humors. In these 
cases a little hot or cold boneset tea is often serviceable, and for heartburn and 
sour stomach cannot be excelled. Many persons are subject to fits of heartburn, 
and sour stomach, and attacks of wind, whose health is otherwise good. Hot 
herb tea relieves these difficulties at once, and without any trouble. But always 
remember that a cure depends upon freeing the body of acid humors by purg- 
ing. 

Cancerous Affections. 

The Sarsaparilla Pills were originally made to relieve the terrible burnings 
and prickings of the stomach which arise from supposed incipient cancer or 
scirrhus of the stomach. Hundreds carry the germ of cancer in them. These 
unfortunates have before them, by ordinary practice, usually a slow and painful 
death. The Pills take hold of the roots of the disease and drag them out. 

Nervous and Chronic Cases. 

In cases of supposed ulcers of the lungs, in carbuncles, in boils, in ulcers of 
the legs, in fever sores, in white-swellings, and in all cases of debility and 
scrofula, when Brandreth's Pills do not produce decided benefit after a few 
doses, we would recommend the Sarsaparilla Pills, which have a similar, but 
not the same effect. They are a peculiar purgative, and take hold effectively 
in these cases. Brandreth's Sarsaparilla and Buchu should also be used by all 
persons affected as above. It is true that we have wonderful cures where only 
the Brandreth's Pills were used ; in these cases the patient had invariably a 
good appetite, but when this is not present our rule is at fault. Eor to cure by 
taking out, you must put in. If you purge, you must eat. So when you can- 
not eat you must try these other remedies, which ofien restore your appetite, 
when the road, to health becomes straight by the use of Brandreth's Pills alone. 

Acute and Chronic Disease. 

If we are taken suddenly sick, that is what is called acute disease. Never 
take one or two pills in these cases; valuable time is lost and the strength wasted. 
You want several doses of pills of from four to eight each, according to the bulk 
of individual. Dr. Hazard's method is excellent. See bill of directions, and 
also Book of Authorities, paragraphs 776 to 778. 

Chronic disease is when it has been of some standing ; then you feel your 
way, and even other applications may accelerate a recovery as stated above. 
These will be more fully referred to when we speak upon each disease under 
its particular heading. 

Fatigue, Prostration, Weakness. 

Should prostration be experienced during a course of Brandreth's Pills, yet, 
if the same goes off after a sleep, you may be assured it was only fatigue. Yet 
the proper method is to moderate the dose if the purgation has been thorough. 
Even to suspend its use for a day or two. If you find your health is gaining, 
you may continue to rest. 



PRINCIPLES OF CURE. 241 

The following texts are presented as a proof that purgation was the great 
reliance in ancient days. But it may be said that the purging mentioned is 
spiritually applied, not bodily. True, but it wa5, figuratively applied; from 
whence the figure? Why, from its known effect in the human body. We 
therefore expect that these texts will be taken as Bible Proof of the excellency 
of purgation as a purifier, as a restorer to health of a tainted diseased body, a 
making of it " clean" — i, e., restoring health by cleansing : 

Psalms 51 : 7. — Purge me with hyssop, and I shall be clean, wash me, and 
I shall be whiter than snow. 

Psalms 65 : 3. — As for our transgressions thou shalt purge them away. 

PsalLis 79 : 9. — Deliver us, and purge away our sins for thy name's sake. 

Mai. 3 : 3. — And he shall sit as a refiner and purifier of silver ; and he 
shall purify the sons of Levi, and purge them as gold and silver. 

Matt. 3 : 12. — He will thoroughly purge his floor, and gather his wheat 
into the garner. 

1 Cor. 5 : 7. — Purge out therefore the old leaven, that you may be a new 
lump. 

2 Tim. 2: 21. — If a man therefore purge himself from thee, he shSU be a 
vessel unto heaven, sanctified and meet for the Master's use and prepared unto 
every good work. 

Heb. 9 : 14. — How much more shall the blood of Christy who through the 
Eternal Spirit offered himself without spot to God, purge your conscience from 
dead works to serve the living God. 

Heb. 1 : 3. — Christ, when he had by himself purged our sins. 

Prov. 16 : 6. — By mercy and truth iniquity is purged, and by the fear of 
the Lord men depart from evil. 

Isa. 6 : 7. — And he laid it upon my mouth, and said, Lo this has touched 
thy lips, and thine iniquity is taken away and thy sin purged. 

Isa. 27 : 9. — By this therefore shall the iniquity of Jacob be purged. 

Ez. 24 : 13. — In thy filthiness is lewdness; because I have purged thee 
and thou wast not purged, thou shalt not be purged from thy filthiness any 
more, till I have caused my fury to rest upon them. 

5 Pet. 1 : 9. — But he that tasteth these things is blind, and cannot see afar 
off", and hath forgotten that he was purged from his old sins. 

John 15 : 2. — Every branch in me that beareth not fruit, he taketh away ; 
and every branch that beareth fruit he purgeth it that it may bring forth more 
fruit. 

Ez. 47 : 12. — And the fruit thereof shall be for meat, and the leaf thereof 
for medicine. 

Peter 11 : 9. — Hath forgotten that he was purged from his old sins. 

Purgation the Oldest Curative Means. 

For five hundred years the Romans had no Doctors ; they cured themselves, 
when sick, by purgatives, by baths, and diet. The purgative method is the 
oldest curative means, and dates from the earliest period of the world. Other 
systems and theories have died out, while this has lived on, and now, by means 
of the Excelsior Medical College of New York, we hope will in time absorb 
all other systems of medicine and because it is true. Opposition and mis- 
representation must be expected ; reformers do not usually have snnooth roads. 
But let me speak for my disciples — our trust is in God, our cause, and our 
energies, and the intelligence of the age. Is it to be understood that Brandreth's 
Pills are the only purgative remedy we recommend ? Our experience of these 
Pills converted many of us to a full belief in the pursrative doctrine. We 
believe iu them, and know they are capable of great things, as restorers to 



242 PEINCIPLES OF CURE. 

health, by purging fouhiess from a diseased body, and therefore deserving of 
attention by all who need such aid. But we believe there are many other 
valuable purgatives, alteratives, as well as other excellent assistants for the cure 
of disease, which will be referred to in a future article, and the Sarsaparilla 
Pills is one other, which see next page. 

Remarks by our Philosopher, 

But no medicine alone cures disease. In fact perhaps it were better to only 
claim that the best only takes away the impediments to the recovery of health, 
the depraved humorers from the blood. Purgatives, whose action is innocent, 
are all that is really called for, in connection with Pure Air, and all the exercise 
the body can bear, with plain food. Even bad cases of consumption, have 
been cured by this method. The late Dr. Marshall Hall facetiously observed : 

" If 1 were seriously ill of consumption, I would live out doors day and 
night, except in rainy weather or mid-winter ; then I would sleep in an un- 
plastered log house. Physic has no nutriment, gasping for air cannot cure 
you, monkey capers in a gymnasium cannot cure you, and stimulants cannot 
cure. What consumptives want is air, not physic — pure air, not medicated 
air — plenty of meat and bread." 

If to this treatment, the doctor had added Allcock's Plasters, when a local 
tonic or strengthener was called for ; and the use of a purgative or alterative 
when the bowels needed assistance, the fame of his advice, would have caused 
thousands of consumptives to regain their health, whose forms are now in the 
grave. Brandreth's Pills, and the Sarsaparilla Pills should be always handy 
for the consumptive. 

This method of cure by cleansing the blood has had great success, and each 
day is becoming more favorably known. All disease is due to an alteration of 
the humors. In other words, some one or more of the humors of the body have 
become vitiated; and to cure the disease and reduce pain, must be by taking 
out the bad and replacing with good humors from the food. The health cannot 
be impaired without affecting the blood, and the blood will again affect the 
health. Thus we go from bad to worse. We eat to repair our losses ; if the 
digestion is good we soon recover our health, but if not, our blood gets worse 
and worse, and then it is only by purgation that we can recover the balance 
and get our bodies again on the road to health. 

In fact, evacuations are the true means by which the purity of the humors 
can be recovered, because by the bowels must be expelled the poisons from the 
blood, whose presence threaten life. Some persons have an idea that purging 
takes out from the body elements other than those which produce disease. It 
may be so with some purgatives, but not with those we employ. Ours remove 
only evil or depraved humors, which are replaced by sound new blood from 
an ordinary meal. And the treatment continued usually soon restores the 
blood, and all the humors, to that state of pureness which constitutes health. 

The medicines that are safe and sure are Brandreth's Pills or the 
Sarsaparilla Pill (sole Life Addition). These medicines, separate or together, 
will be found worthy. They come well recommended by millions of our citi- 
zens. And have the largest sale of any pills in the world. 

Prepared by B. Brandreth, M.D., Sing Sing, N. Y. Principal office, 
Brandreth House, and sold by all druggists. Price, 25c. with full directions. 



INDEX OF DISEASES. 



PARAGRAPHS. 

Abscesses 28, 30, 140, 67, 97, 329 

Acute Disease 4, 20, 59, 191, 220 

Ague 577, 678 

Amenorrhea 576 

Anemia r 658, 668 

Angina Pectoris 522 

Anorexia 344, 702 

Apoplexy. , . .41, 143, 144, 181, 256, 278, 832, 
354, 484, 552, 691 

Asthma 209 

Autumnal Disease 17, 112, 160, 221 

Blindness 41, 99 

Buboes 90, 109, 240 

Bright's Disease Preface. 

Caeliac Passion 129, 135 

Cachexia , 114,625 

Cancer 71, 614, 700 

Carbuncles 109 

Cardialgia 524 

Cams 144 

Catarrh 609 

Cerebral Diseases , 514, 619, 702 

Chlorosis 307, 315, 664, 680 

Cholera 162, 484, 568, 596 

Chorea 311, 321, 508, 549, 597 

Chronic Diseases 155, 159, 317, 485, 614 

Colic 65, 82, 138, 255, 418, 526, 428,618, 685 

Concussion of Brain 99 

Constipation 291, 292, 487, 527, 528, 570, 724 

Consumption 323, 370, 382, 626, 627 

Convulsions 41, 428, 706 

Costiveness 246, 305, 307, 524 

Cramps 210, 217 

Croup, . , , , , 218 

Deafness 27 

Debility 169, 223, 234, 241, 246, 279, 303, 

323, 344, 409, 454, 585, 663 

Delirium 183, 452 

Diabetes 81, 362 

Diarrhea. . .2, 13, 69, 135, 142, 215, 252, 362, 

397, 435, 530, 599 

Dropsy 35, 38, 73, 211, 304, 362, 374, 603, 663 

Dysentery 38, 136, 198, 214, 221, 253, 285, 

352, 453, 541 

Dyspepsia 244, 507, 563, 131, 333, 555, 

^ 568,731 

Enteritis 609 

Enterocele 83 

Epilepsy 150, 231, 306,355, 440, 447,486,488 

Erysipelas 77, 474, 492, 667 

Eruptions of the Skin 247, 542 

Eruptive Fevers 274, 543 

Eye Disease .36, 80 



PARAGRAPHS. 

Fever. ... 30, 81, 37, 45, 51, 67, 87, 106, 114, 
152, 153, 159, 182, 190, 191, 194, 196, 
202, 203, 204, 208, 212, 245, 280, 282, 
801, 349, 362, 363, 368, 369, 370, 387, 
419,422,423,424, 452, 455,463,466, 
493, 518, 537, 538, 546, 547, 558, 565, 
630, 632, 638. 644, 656, 668, 678, 703, 
708, 718, 734. 

Fits 350 

Flatulency 73, 82, 85 138, 151 

Fractures 100, 222, 228 

Foul Gases. 701 

Gangrene 78 

Gastritis 370 

Gastrodynia 417 

Gout. , 40, 84, 85, 86, 158, 377, 378, 379,420, 
436, 439, 495, 522, 671, 692 to 697 

Gravedo 645 

Gravel 624 

Gripings 21, 24, 599 

Headache 181, 605 

Head Disease 132,442 

Heart Disease 464 

Hemiplegia 201, 332 

Hemorrhoides 71, 180 

Hepatic Complaint 216 

Hepatitis. 553 

Hernia 230, 326, 343, 682, 651 

Hydrocephalus, , 225, 227, 232, 238, 353, 679 

706 

Hydrophobia 95, 313 

Hypertrophy 663 

Hypochondria 544 

Hysteria.,... 310, 549,618 

Iliac Passion 137 

Indigestion 131, 333, 655, 731 

Infantile Diseases 226, 235, 428 

Inflammation. .. 72, 81, 89, 114, 141, 136, 218, 

482, 639, 653,655, 660, 715, 746, 751, 

564, 574, 641. 

Influenza 257, 258, 738 

Insensible Perspiration 102, 105, 706 

Insanity 567 

Intestinal Inflammation 482 

Jaundice. 254, 535, 536, 568 

King's Evil .^ 192 

Leprosy. , 94 

Lethargy 144 

Lientery 38, 128, 136 

Liver Disease 668,690 

Local Disease. 331, 440 



244 



INDEX OF DISEASES. 



PARAGRAPHS. 

Lumbago 472, 645 

Malaria 568 

MaUgnant Diseases 383, 384, 385 

Malis^nant Fever 67, 106, 229, 399, 400 

Mania 41, 148, 448 

Marasmus 305, 315 

Measles 64, 92, 271, 379, 479 

Melancholy 147 

Menorrhagia 362 

Menstruation 33 

Mental Depression 575 

Mercurial Diseases 226, 242, 243 

Mesenteric Aflfection 141, 223 

Miasmata , 281, 591 

Milk Fever ,,,,,, ,336, 606, 632 

Nausea 138, 240, 344 

JS'ephritis 370 

Nervous Diseases 120, 447, 459, 489 

Neuralgia 460, 490, 568 

Neurosis 448-548 

Obstruction 413 

Ophthalmia 36, 80, 239, 274 

Pains 22, 52, 137, 138,184 

Pains in the Back 138, -141 

Palpitation 314,464, 573 

Palsy 76, 151, 159, 181, 201, 497 

Paralysis , 341 

Paraplegia 201 

Paraphrenitis 146 

Pericarditis 744 

Peripneumonia 

Peritonitis 505 

Phthisis 18 

Phrenitis 146 

Piles 1 80, 533 

Plethora. .^ 15, 60, 104 

Pleurodynia 645 

Pleurisy 92, 166,480,521 

t^aenmocy 380, 381, 607, 638, 743, 753 



PARAGRAPHS. 

Prickly Heat 262 

Purpura .433 

Plague 96, 109, 240 

Puerperal Fever 208, 632, 644 

Rheumatism 370, 379,419,467-471, 509, 559- 

562, 568, 609, 635, 645, 674, 715, 716, 721 

Ringworm 91, 5lV 

Scarlet Fever 164, 277, 303, 416 

Sciatica 88, 472, 645 

Scrofula , 498 

Scirrhus 73 

Small Pox 64, 92, 379, 431, 643, 748 

Spasmodic Diseases 217, 350, 366, 618 

Squinancy 92 

Sore Throat 72, 475 

Strangury 89, 285 

Structural Diseases 

Syphilis 638, 639, 668-9 

Sweats, 43, 10^, 182, 190, 193, 195, 205, 206, 

207, 398, 723 
Synocha 218,237 

Tetanus 76, 312, 340, 365, 367 

Toothache 523 

Torpor of Intestines 134, 345 

Torticollis 

Tumors 34, 67, 70, 634 

Tetters 91 517 

Typhus,, 218, 233, 297, 358,428 430, 434,454, 

300, 303 483, 620, 539, 540, 583, 

623, 647, 668. 

Ulcers 49, 79, 140, 329, 481, 687 

Vertigo ; 145 

Vitiated Blood 122 

Worms 93, 355, S56, 357, 532, 617 

Yellow Fever, 229, 249, 260, 261, 262, 263, 
264, 370, 385, 402 



INDEX OF AUTH0E8 QUOTED. 



PARAGKAPH, 

Abercrombie 7 ..... . .563, 564 

Abernethy 315, 341 

Addison 749 

African Savage 383 

Ainsie 553 

Allen , 

Alison 661 

Andral 550, 555, 556, 55Y, 592 

Annesly 565, 566 

Aretseiis 256 

Armstrong 430, 432 

Asclepiades 63 

Auld 245, 246 

Avicenna 65 

Badger 247, 248 

Bancroft 540 

Bardsley 257 

Barlow 410, 421 

Bartlett 688, 689 

Bayle 567 

Bache 209 

Beclard 592 

BeU, Benj 228 

Bell, John 228 

Bennet, J. Henry 743-746 

Bennet, J. H'ghs 747-757 

Bennion 282-284 

B. G. B 422, 423 

Bichat 592 

Blegborough 342 

Boyle 494 

Bradley 343 

Briggs 365-367 

Brown, John 568 

Bryce 408 

Buchan 417 

Budd 690 

Burserius 434 

Canstadt 657-664 

Carpenter 736 

Caristo 

Carson 226, 227 

Chambers 568 

Chapman, John N 228 

Chapman, N 495-497 

Cheyne 350-353 

Chomel 623 

Clark, Dr 397 

Clark, Thomas 285 

Clark, James 625, 626 

Clark, Joseph 428, 429 

Cleghorn 384 

Clendenning 706 

Collins 127-151 

Combe 628, 629 



PARAGRAPH. 

Connoly .....' ; 627 

Conradi 210 

Cooke 569-578 

Copeman 691 

Copland ." 586-621 

Cozzi 685 

Crampton 517 

Crichton 668, 669 

Cullen 202 

Currie. 249, 251 

Denman 211 

Dick 724, 725 

Dickson, D. J. H 450,454 

Dickson, S. H 737-742 

Dropes 455-458 

Forbes 630-640 

Fowle 229 

Frank 538 

Franklin 385 

Friend '423 

Fricke 559 

Galen 79 

Gregory 218 

Gay.... ' 354 

Geoghegan 230 

Good 523-544 

Gully 670 

Halliday 355-358 

Hall 707, 708 

Hamilton, James 286, 319 

Hamilton, John 480, 481 

Harrison 709, 710 

Hartz 433, 434 

Harvey, William 121-126 

Harvey, Gideon 167-182 

Harvey, James 183-191 

Haspel 734, 735 

Haygarth 540 

Hazard 761-776 

Heberden 252-255 

Heller 740 

Henderson 212-217 

Hillary 397 

Hippocrates 1-62 

Hosack 518-52^ 

Houston 686 

Huenefeldt 665 

Huggan 218 

Humboldt 399 

Hunter 325 

Jones 671 

Johnson. Ed 727-732 



246 



INDEX OF AUTHORS QUOTED. 



PARAGRAPH. 

Johnson. Jas... , 482, 493 

Kennedy. 652 

Kingslake 258, 259 

Kirkland 396 

Kramer 740 

Laennec 624 

Lane 

Lanza 672-673 

Lawrence 651 

Leeson 711, 712 

Lemazurein 467 

Liebig 727 

Lind 403 

Lloyd 498 

Louis, Ch. A 641, 642 

Louis, E. H 643 

Mackin 692-697 

Magendie 713, 714 

Markham. . „ 

Magennis 231 

Marx ..622 

Martin 424,426 

Mcllwain 646 

McCullock 568 

McKenzie 581 

McLeod 674 

Mead 543 

Meterius 87 

E: Miller 219, 220 

Mitchell 390 

Moore, I 237 

McMiiUen 320-324 

M iicus. Pathology 435-446 

Me icus 277 

Miller 205-207 

Monat and Henderson 579, 580 

Moore, G 644 

Morgan, Chas 344-348 

Morgan, G. F 653-656 

Mosely 396 

Manneley 666, 667 

MckoU 499 

Nooth 221 

O'Berne 260-279 

(Esterlein 740 

Parey 66-100 

Paris 545-552 

Parise 645 

Patterson 278 

Pearson 279-281 

Pennington 391 

Philip 



PAEAGRAPH. 

Pickford 758-760 

Pidduck 687 

Pott 228 

Potter 271-273 

Power 274, 275 

Pring 505-516 

Pringle 193-201 

Pricards *. 238 

Pritchard 447-449 

Redman , 396 

Reeve 232 

Rhazes 64 

Richter 675-679 

Robertson 203, 204 

Rush 368-409 

Sanctorius 101-120 

Sara 698, 699 

Savaresi 239 

Say 396 

Schultz 680, 681 

Scudamore 559-562 

Selle 208 

Shaw 500, 504 

Sherwood 726 

Skimshire 222 

Stephens 582 

Stoker 583, 585 

Strack 434 

Sutton 223, 224 

Sydenham 152-166 

Taylor 700 

Tuomey 424-426 

Tainsh 240 

Tyro 256 

Unwins 323, 324 

Vage 241, 244 

Vandeswieter. 256 

Velpeau 592 

Yogel 701 

Waddley 276 

Waddy 702, 705 

Walsh 349 

Watt 359-364 

Wegg 733 

White 225 

Whydt 598 

Willan , 192 

Williams, C. J. B 682-684 

Williams, Robert 647-650 

Wilson, Andrew 459-479 

Wilson, J. A 715-723 

Woodward 235, 236 



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